{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"D ALEMAPGNIRREH ","gend":1,"add":"                ESORP YOJ                         ","city":"FOREST                   ","state":"VA","zip":"24551-3562","dob":"1966-10-13","age":"","mstatus":"","insh":"00114312","cliId":"","pno":"9204569217","cno":"","email":"","ename":"","eno":"","pphy":"HINKLE, LEAH H","ppno":4345256964,"pcpadd":"1175 CORPORATE PARK DR,","pcpcity":"Forest","pcpstate":"VA","pcpzip":245512238,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"1419   GLADDEN CIRCLE                             ","add3":"","madd1":"JOY PROSE                                         ","madd2":"1419   GLADDEN CIRCLE                             ","madd3":"","mcity":"FOREST                   ","mstate":"VA","mzip":"24551-3562","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R39.81","U07.1","M79.605","E66.01","G80.9","G40.909","F32.0","Z68.41","E22.2","F31.9","M25.562","K21.9","Z23","J30.9","L29.8","T14.8XXD","R51.9","K59.00","E63.9","I89.0","M81.0","K64.9","F32.1","R26.9","Z68.39","Z71.89","F33.1","G40.802","F70","M25.572","R60.9","H60.399","M62.81","R27.9","R41.841","M21.541","M21.542","R27.0","S99.912A","S79.912A","S79.922A","M25.462","G40.209","E87.1","T42.1X5A","E87.5","F44.5","H92.09","G89.29","E66.9","F32.9","G44.229","M72.2","F39","Z91.89","Z76.89","C71.6","R32","Z99.3","M17.32","M19.172","M25.522","S52.002A","M79.672","Z01.419","E78.5","L29.9","R51","T14.8XXA","Z13.1","Z12.4","Z00.00","Z13.31","Z00.01","J01.90","M19.029","R68.89","H90.3","Z12.31","Z28.29","H92.03","Z20.822","J02.9","R05.9","H91.93","H73.891","H61.22","H69.92"," ","R42","W19.XXXA"],"date":["2022-10-27","2022-06-22","2022-01-26","2022-01-26","2022-01-26","2022-08-09","2021-01-04","2021-01-04","2022-01-26","2022-05-24","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2019-04-23","2022-08-09","2020-02-06","2019-05-18","2019-04-29","2019-04-29","2019-04-30","2019-04-30","2019-05-03","2019-05-15","2019-05-15","2019-06-14","2019-05-17","2019-05-17","2019-05-17","2019-05-18","2019-05-18","2019-07-22","2019-05-18","2019-05-18","2019-06-14","2019-06-10","2019-05-18","2019-05-18","2019-06-14","2019-05-18","2019-07-22","2019-06-14","2019-05-18","2019-05-30","2019-07-22","2019-06-14","2019-06-14","2019-12-05","2019-12-05","2021-11-30","2021-11-30","2018-09-06","2018-10-11","2022-04-04","2020-11-11","2019-10-28","2018-10-11","2018-10-11","2018-10-11","2022-04-07","2019-10-28","2022-04-04","2019-11-21","2021-11-30","2022-06-22","2022-05-16","2022-05-25","2022-04-07","2022-06-20","2022-06-22","2022-06-22","2022-06-22","2022-04-11","2022-04-11","2022-04-11","2022-03-02","2022-10-27","2022-08-09","2022-08-09"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","55111025860","ZIPRASIDONE","CAP 60MG","60","Select","Select",""],["","69097022416","ALENDRONATE","TAB 70MG","12","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","60","Select","Select",""],["","55111015834","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00832031011","VALPROIC","CAP 250MG","360","Select","Select",""],["","13668026801","CARBAMAZEPIN","TAB 200MG","120","Select","Select",""],["","69097081307","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","13668044201","CELECOXIB","CAP 200MG","180","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21.00","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","49884093547","DICLOFENAC","GEL 0.01","500","Select","Select",""],["","00781217660","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}