{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YRAMEDOOG","gend":1,"add":"G WEN 1151DAOR EVOR","city":"KENBRIDGE","state":"VA","zip":"23944-9998","dob":"1988-02-19","age":"","mstatus":"","insh":"8979110*50","cliId":"","pno":"43\/2522910-3","cno":"","email":"","ename":"","eno":"","pphy":"POWERS III, GRAHAM H MD","ppno":"434\/584-2025","pcpadd":"514 W ATLANTIC ST","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":23970,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","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":["M53.3","M51.26","M47.817","M41.86","G89.4","M70.62","R19.4","R10.9","M54.5","R10.12","M35.9","Z51.81","M54.9","M17.0","R19.5","N64.4","M25.561","M25.562","M54.2","M77.12","M25.50","H81.13","Z23.","Z68.44","G56.02","G56.22","E66.01","K82.4","K76.0","M77.9","M54.31","K81.1","H66.92","Z00.00","Z87.891","K21.9","M35.1"],"date":["2021-01-18","2020-02-06","2021-01-18","2021-01-18","2021-01-18","2020-02-18","2021-05-05","2021-05-05","2020-06-29","2021-05-05","2020-12-17","2020-12-17","2020-12-17","2020-01-14","2021-04-02","2021-04-29","2019-07-01","2019-04-24","2019-02-08","2019-12-19","2019-12-02","2019-12-02","2019-12-02","2019-12-02","2019-09-26","2019-06-06","2019-10-23","2019-09-10","2019-09-10","2019-12-19","2019-11-22","2019-10-23","2019-06-03","2019-01-02","2019-01-02","2019-01-02","2019-01-02"],"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":[["","00904759080","FEROSUL","TAB 325MG","90","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","47335023583","METHOTREXATE","TAB 2.5MG","30","Select","Select",""],["","","DICLOFENAC","GEL 0.01","","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","9","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","9","Select","Select",""],["","","BENZONATATE","CAP 100MG","","Select","Select",""],["","68645049254","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","43598072101","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","62332014231","CELECOXIB","CAP 200MG","60","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","00591367101","NABUMETONE","TAB 750MG","60","Select","Select",""],["","00093015010","APAP\/CODEINE","TAB 300-30MG","15","Select","Select",""],["","11534016503","FOLIC","TAB 1MG","30","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00071101668","LYRICA","CAP 150MG","60","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","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":["",""],"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":""}]}]}