{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"F K NNANIATNUO","gend":1,"add":"             DR SEVIR 105                         ","city":"MARTINSVILLE             ","state":"VA","zip":"24112-9998","dob":"1958-09-01","age":"","mstatus":"","insh":"10119602","cliId":"","pno":"0267260951","cno":"","email":"","ename":"","eno":"","pphy":"MAHONEY, MARK T","ppno":2766660500,"pcpadd":"100 COLLEGE DR,","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241127588,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"501 RIVES RD                                      ","madd2":"                                                  ","madd3":"","mcity":"MARTINSVILLE             ","mstate":"VA","mzip":"24112-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","I82.619","R16.0","K13.0","R73.09","L02.214","E11.9","K21.9","M10.9","Z88.6","G89.29","Z79.899","R13.10","R04.0","I95.1","R07.9","R00.2","R06.02","R42","D38.5","J31.0","L03.019","H65.92","M79.671","M79.89","Z86.79","Z79.891","Z79.01","Z87.891","R60.0","D35.00","I82.721","G47.00","M17.0","Z76.0","Z51.81","M10.071","Z79.84","F17.210","M79.604","G89.4","M71.9","M25.50","M54.5","Z53.09","Z79.02","E11.65","H52.4","Z23","M54.50","M19.90","Z88.5","J02.9","J01.90","H25.813","T26.12XA","T26.62XA"," ","J09.X9","R07.89","J20.9","Z20.822","Z86.718","J98.01","J09.X2","R05.1","J18.9","R05.9","R09.81","R50.9"],"date":["2022-11-25","2021-04-06","2021-11-04","2021-04-06","2021-04-06","2022-01-26","2022-01-26","2022-11-25","2022-01-26","2022-11-25","2021-03-19","2021-10-10","2021-03-19","2021-03-19","2021-03-19","2022-11-22","2021-03-19","2022-11-25","2021-03-19","2021-03-19","2021-04-06","2021-04-06","2020-09-15","2020-08-26","2020-06-20","2020-06-20","2021-10-10","2022-11-25","2022-11-25","2020-06-20","2021-11-03","2021-11-03","2021-11-03","2021-07-20","2021-07-20","2021-07-20","2020-08-26","2021-08-12","2020-07-24","2020-07-24","2020-08-04","2020-08-04","2020-08-04","2020-08-04","2021-08-12","2021-08-12","2022-03-08","2020-09-10","2021-11-03","2021-10-10","2021-10-10","2021-10-10","2020-10-28","2020-10-28","2022-03-08","2022-02-28","2022-02-25","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2022-11-25","2022-11-22","2022-11-22","2022-11-22","2022-11-18","2022-11-18","2022-11-18"],"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":[["","00406052201","OXYCOD\/APAP","TAB 7.5-325","90","Select","Select",""],["","68180052002","LISINOP\/HCTZ","TAB 20-25MG","90","Select","Select",""],["","00378718505","METFORMIN","TAB 500MG","90","Select","Select",""],["","68382039801","POT  CHLORIDE","TAB 20MEQ ER","90","Select","Select",""],["","16729013401","ALLOPURINOL","TAB 100MG","90","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","90","Select","Select",""],["","00591534701","PROBENECID","TAB 500MG","5","Select","Select",""],["","53489012002","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00143301801","COLCHICINE","CAP 0.6MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","30","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","90","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","15","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","61314063006","NEO\/POLY\/DEX","SUS 0.1% OP","5","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","00713072715","MOMETASONE","OIN 0.001","30","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}