{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRIANNA MOORE","gend":1,"add":"2656 HALESFORD ROAD","city":"MONETA                        ","state":"VA","zip":"24121-5667","dob":"2003-07-28","age":"","mstatus":"","insh":4479891,"cliId":"","pno":4346653020,"cno":"","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":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"2656 HALESFORD ROAD","add3":"","madd1":"2656 HALESFORD ROAD","madd2":"","madd3":"","mcity":"MONETA                        ","mstate":"VA","mzip":"24121-5667","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.9","Z30.40","M54.5","M99.00","M99.01","M99.02","M99.03","M99.05","M99.04","M54.6","V89.2XXA","Y92.410","M99.08","N39.0","B96.20","Z30.09","Z11.1","Z11.3","N93.0","H65.90","B37.3","R35.0","M41.129","M54.2","G44.89","Z00.129","Z01.00","H92.03","Z30.42","F32.0","F41.1","Z23","U07.1","R09.81","R05","R43.9","M54.50","M25.562","N94.10"],"date":["2020-03-09","2020-06-17","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2020-01-23","2020-01-23","2020-05-26","2020-05-04","2020-05-04","2021-05-14","2021-07-16","2021-11-05","2020-09-08","2020-10-06","2020-12-17","2020-12-17","2021-01-07","2021-01-07","2021-01-07","2021-02-17","2021-02-17","2021-05-12","2021-11-05","2021-10-28","2021-07-16","2021-07-27","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-10-28","2021-10-28","2021-11-05"],"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":[["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","17478071130","LIDOCAINE","GEL 2% JELLY","30","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","16571040110","CETIRIZINE","TAB 5MG","30","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","43547039950","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","57237003105","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","64679096105","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","70461041910","FLUCLVX","INJ 2019-20","0.5","Select","Select",""],["","68180030260","CEFUROXIME","TAB 250MG","20","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00472016630","NYSTATIN","OIN 100000","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","58657045001","PHENAZOPYRID","TAB 100MG","9","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":""}]}]}