{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TYFFANI   M SIGAFOOS","gend":1,"add":"211 SAINT AUGUSTINE STREET","city":"LYNCHBURG                     ","state":"VA","zip":"24501-3341","dob":"2002-11-18","age":"","mstatus":"","insh":4470097,"cliId":"","pno":4344266488,"cno":4344266450,"email":"","ename":"","eno":"","pphy":"WRIGHT, RONNA K","ppno":4345822273,"pcpadd":"131 Jones St,","pcpcity":"Appomattox                    ","pcpstate":"VA","pcpzip":245229830,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"211 SAINT AUGUSTINE STREET","add3":"","madd1":"211 SAINT AUGUSTINE STREET","madd2":"","madd3":"","mcity":"LYNCHBURG                     ","mstate":"VA","mzip":"24501-3341","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O76","O36.5930","Z37.0","Z3A.39","O77.9","O36.5990","Z3A.00","O80","Z39.2","R09.89","O99.282","E75.6","Z3A.38","D89.89","N91.2","Z86.2","O23.42","O20.9","Z3A.14","Z79.82","Z14.8","O34.211","Z98.891","O09.892","Z3A.19","O99.112","Z3A.23","Z87.59","O42.912","E73.9","O99.284","Z91.018","Z91.02","Z91.048","Z79.899","Z82.5","Z83.3","Z80.49","Z82.0","O44.12","O34.219","Z3A.27","O44.52","O09.93","O44.03","Z3A.29","Z3A.30","Z3A.34","Z3A.35","O44.13","O09.893","O44.00","O99.513","O60.14X0","Z3A.36","Z88.8","B37.0","R21","H66.003","Q27.9"],"date":["2020-01-01","2020-12-31","2020-12-31","2020-01-01","2020-01-01","2020-01-01","2020-12-31","2020-12-31","2021-01-01","2020-01-04","2020-10-02","2020-10-02","2020-03-28","2020-09-02","2020-06-15","2020-06-15","2020-07-15","2020-07-15","2020-07-29","2020-10-27","2020-12-31","2020-12-31","2020-12-23","2020-12-23","2020-09-02","2020-09-02","2020-10-02","2020-12-23","2020-10-27","2020-10-27","2020-10-27","2020-12-31","2020-10-27","2020-12-31","2020-10-27","2020-10-27","2020-12-31","2020-12-31","2020-10-27","2020-10-28","2020-12-31","2020-10-28","2020-10-27","2020-11-11","2020-12-31","2020-11-11","2020-11-19","2020-12-15","2020-12-23","2020-12-22","2020-12-22","2020-12-31","2020-12-23","2020-12-31","2020-12-31","2020-12-31","2021-01-15","2021-06-17","2021-08-26","2021-11-30"],"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":[["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","24","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","84","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","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":""}]}]}