{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   RIALBPALNUD H","gend":0,"add":"8 B612TS HT6","city":"VIRGINIA BEACH","state":"VA","zip":"23451-9998","dob":"1953-04-04","age":"","mstatus":"","insh":"73000910*721","cliId":"","pno":"35\/7574214-6","cno":"","email":"","ename":"","eno":"","pphy":"KILLEN, JOSEPH MD","ppno":"757\/481-2333","pcpadd":"1120 FIRST COLONIAL RD STE 101","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":"","pcpname":"Privia - First Colonial Family Practice","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H52.7","F90.0","C43.60","M65.30","C43.9","G47.00","R13.12","Z20.828","L98.9","Z85.828","Z85.820","L98.499","Z20.822","H40.1131","D48.5","Z04.3","R60.0","Z12.11","H93.12","K21.9","C44.92","L28.0","S81.811A","W01.0XXA","Y92.89","Y93.89","E78.5","Z12.5","K22.4","K44.9","L25.9","H04.123","L30.9","L57.0","N52.9","L21.9","L28.1","D22.9","D17.9","H25.13","H43.813","H90.42","Z00.00","Z48.02","R22.9","M79.674","M12.871","L85.1","M25.774","S81.801D","L03.115","D23.9","D18.01","L82.1","L81.4","L85.3","M20.42","M20.41"],"date":["2020-02-05","2020-10-02","2020-10-01","2020-10-02","2020-10-02","2022-08-17","2020-10-23","2020-10-05","2021-10-08","2022-07-06","2022-04-04","2021-10-08","2021-11-14","2022-05-26","2022-06-08","2021-08-28","2021-09-22","2022-05-28","2020-10-23","2020-10-08","2021-01-28","2021-07-15","2021-08-28","2021-08-28","2021-08-28","2021-08-28","2021-12-08","2021-12-08","2020-10-08","2020-10-08","2020-11-25","2022-04-14","2021-04-15","2022-01-11","2022-08-17","2022-07-06","2020-09-09","2020-12-14","2021-03-11","2021-09-21","2021-09-21","2020-10-23","2020-10-27","2021-02-18","2021-02-18","2022-03-04","2021-04-01","2021-04-01","2021-04-01","2021-09-18","2021-09-18","2022-06-08","2022-01-11","2022-07-06","2022-07-06","2022-04-04","2022-03-04","2022-03-04"],"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":{"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":[["","47781017601","AMPHET\/DEXTR","TAB 10MG","60","Select","Select",""],["","00781531601","ZOLPIDEM","TAB 12.5MG","-30","Select","Select",""],["","42571014726","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","8","Select","Select",""],["","27241006903","SILDENAFIL","TAB 100MG","30","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","62332000131","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","-1","Select","Select",""],["","00168009960","KETOCONAZOLE","CRE 0.02","-30","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","14","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","1","Select","Select",""],["","00168008031","HYDROCORT","CRE 0.025","30","Select","Select",""],["","51672411806","FLUOROURACIL","CRE 0.05","-40","Select","Select",""],["","68462019255","MOMETASONE","CRE 0.001","45","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","-30","Select","Select",""],["","69315090405","LORAZEPAM","TAB 0.5MG","-30","Select","Select",""],["","00527280332","VARDENAFIL","TAB 20MG","10","Select","Select",""],["","42571025101","CLINDAMYCIN","CAP 150MG","41","Select","Select",""],["","31722095801","BENZONATATE","CAP 200MG","30","Select","Select",""],["","72578005505","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","49281072210","FLUBLOK","INJ 2022-23","0","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}