{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YNAFFITSEHGUH ","gend":1,"add":"H TM 1912DR YNOMRA","city":"KEYSVILLE","state":"VA","zip":23947,"dob":"1980-06-20","age":"","mstatus":"","insh":"10113052","cliId":"","pno":"1343492835","cno":"","email":"","ename":"","eno":"","pphy":"YORK, LISA M","ppno":4343153829,"pcpadd":"514 W ATLANTIC ST,","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":23970,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"Western\/Charlottesville","aligned":"Y","ano":"","add2":"APT B-5","add3":"","madd1":"2191 MT HARMONY RD                                ","madd2":"APT B-5                                           ","madd3":"","mcity":"KEYSVILLE                ","mstate":"VA","mzip":"23947-4136","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O10.92","O24.12","Z37.0","O99.354","Z3A.38","O99.02","D64.9","O99.344","F32.9","G47.33","O99.214","E66.9","Z82.49","Z83.3","E11.9","S83.242A","O09.522","O10.413","O24.313","O09.93","N18.6","F43.10","O80","Z3A.00","Z01.818","O09.529","Z3A.37","O99.013","O26.893","R51.9","H53.9","O24.113","O09.523","Z87.891","Z79.84","R07.89","N91.2","R10.2","R68.84","K08.89","Z33.1","I10","O99.210","I97.3","Z68.33","Z32.00","O09.521","Z31.430","Z34.81","Z36.0","I51.7","R07.9","Z11.3","M25.562","Z20.822","R73.03","Z79.899","Z30.09","Z30.2","Z39.2","N94.6","N97.0","R76.8","S82.002A","N93.9","O26.891","K04.7","Z3A.01","O16.1","O24.911","Z79.82","Z68.38","Z12.4","Z11.51","O09.512","O10.412","Z3A.18","O24.812","R09.81","O24.415","Z3A.33","O24.419","O10.013","O10.011","O24.811","Z3A.10"," "],"date":["2021-02-22","2021-02-22","2021-02-23","2021-02-22","2021-02-23","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-02-22","2021-10-06","2021-02-22","2021-02-22","2021-02-22","2021-09-13","2021-02-08","2021-02-17","2021-02-08","2021-02-08","2022-03-21","2022-11-17","2021-02-23","2021-02-23","2022-03-21","2021-02-15","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2021-02-17","2022-04-30","2020-08-12","2022-03-09","2020-10-02","2020-10-02","2020-10-02","2021-10-06","2021-01-27","2020-07-14","2020-07-14","2020-07-14","2020-08-12","2020-08-12","2020-08-12","2020-08-12","2022-03-21","2022-04-30","2022-02-16","2021-08-30","2021-12-28","2021-10-06","2021-10-06","2021-03-10","2021-03-10","2021-03-10","2022-03-09","2022-03-09","2022-03-09","2021-08-30","2022-02-16","2020-07-18","2020-07-18","2020-07-18","2020-07-18","2020-07-18","2020-07-18","2021-10-06","2020-08-12","2020-08-12","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2020-08-12","2020-08-12","2020-08-12","2022-11-17"],"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":[["","13107015590","PAROXETINE","TAB 20MG","90","Select","Select",""],["","00603548332","PROPRANOLOL","TAB 20MG","60","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","30","Select","Select",""],["","70010006510","METFORMIN","TAB 1000MG","60","Select","Select",""],["","69097012815","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65162089909","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","14539067501","HYDROXYZ","CAP 50MG","90","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","53885039310","ONETOUCH","MIS LANCETS","100","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","16729020101","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","63304069201","CLINDAMYCIN","CAP 150MG","56","Select","Select",""],["","57237004230","VALACYCLOVIR","TAB 500MG","90","Select","Select",""],["","00527169501","BUT\/APAP\/CAF","TAB ","42","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":["",""]}},{"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":""}]}]}