{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" L DRAWDEDROFWARC","gend":0,"add":"ELLAV 801RD WEIV Y","city":"Altavista","state":"VA","zip":"24517-9998","dob":"1998-04-19","age":"","mstatus":"","insh":"10119197","cliId":"","pno":"0243497959","cno":"","email":"","ename":"","eno":"","pphy":"FOSTER COCKE, SARA BETH","ppno":4345346868,"pcpadd":"1088 LONDON LINKS DR,","pcpcity":"Forest","pcpstate":"VA","pcpzip":"24551-4662","pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"108 VALLEY VIEW DR","madd2":"","madd3":"","mcity":"Altavista","mstate":"VA","mzip":"24517-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Q90.9","M54.6","M41.84","G89.29","M54.59","G47.33","M54.9","M41.9","Z00.01","G47.9","L30.9","J30.9","H50.43","K04.7"],"date":["2022-07-11","2023-03-02","2023-03-02","2023-03-02","2023-03-02","2023-07-21","2022-09-27","2022-09-27","2022-04-14","2022-04-14","2022-04-14","2022-04-14","2022-09-01","2023-02-23"],"priorHcc":["","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","63646001004","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","66689002316","HYDROCO\/APAP","SOL 7.5-325","105","Select","Select",""],["","00093412773","PENICILLN VK","SOL 250\/5ML","200","Select","Select",""],["","45802095226","IBUPROFEN","SUS 100\/5ML","1080","Select","Select",""],["","00093412773","PENICILLN","SOL 250\/5ML","200","Select","Select",""],["","63646001004","KETOCONAZOLE SHA","2%","120","Select","Select",""],["","66689002316","HYDROCO\/APAP SOL","7.5-325","105","Select","Select",""],["","00093412773","PENICILLN VK SOL","250\/5ML","200","Select","Select",""],["","45802095226","IBUPROFEN SUS","100\/5ML","1080","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}