{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT   S TURNER","gend":0,"add":"826   HARDY DRIVE                                           ","city":"CHARLOTTESVILLE               ","state":"VA","zip":"22903-4479","dob":"1984-07-30","age":"","mstatus":"","insh":4890615,"cliId":"","pno":4342347099,"cno":"","email":"","ename":"","eno":"","pphy":"CHRISTENSEN, MARISA                                         ","ppno":5409421200,"pcpadd":"1242 Cedars Ct                                              ,                                                            ","pcpcity":"Charlottesville               ","pcpstate":"VA","pcpzip":229034800,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"WESTERN\/ CHARLOTTESVILLE","aligned":"","ano":"","add2":"826   HARDY DRIVE                                           ","add3":"","madd1":"826   HARDY DRIVE                                           ","madd2":"APT C                                                       ","madd3":"","mcity":"CHARLOTTESVILLE               ","mstate":"VA","mzip":"22903-4479","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S69.91XA","S67.10XA","S62.639A","R11.2","R11.10","R19.7","E86.0","K52.9","Z11.3","H91.90","R55","I10","R42","R11.0","Z87.891","R07.9","R00.0","Z86.69","R51.9","Z20.822","J45.909","J45.20","R07.89","F41.9","Q24.9","R41.82","M25.521","S59.901A","F41.1","F43.23","F43.21","R45.851","G43.909","Z56.0","Z59.00","F12.10","F10.10","F41.0","F19.90","M79.651","R10.812","S00.03XA","R40.20","Y04.2XXA","W50.0XXA","R06.00","Z53.29","Z82.49","Z72.0","R00.1","F17.210","Z03.818","M54.2","M54.6","M54.50","M54.9","W17.89XA","Y93.89","Y92.89","Y99.8","S09.90XA","S19.9XXA","S29.9XXA","S39.92XA","S39.82XA","S39.91XA","S39.93XA","W19.XXXD","G89.29","S51.812A","Y28.9XXA","Z23","S61.502A","T14.8XXA","R60.0","S50.12XA","M79.89","X58.XXXA","M79.602","S51.812S","R20.2","M79.9","Z48.02","F12.90","S50.12XD","J06.9","R10.84","Z11.52"],"date":["2020-11-05","2020-11-05","2020-11-05","2022-06-28","2020-12-10","2020-12-10","2022-11-16","2020-12-10","2021-04-05","2021-04-05","2022-05-21","2022-06-28","2021-05-02","2021-04-21","2022-06-28","2022-06-17","2021-04-26","2021-04-26","2021-11-15","2022-11-16","2022-03-13","2021-05-12","2021-12-14","2021-05-12","2021-05-20","2021-11-11","2021-11-11","2021-11-11","2021-11-16","2021-11-15","2021-11-16","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2022-03-13","2021-11-15","2021-11-16","2021-11-16","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2022-03-13","2022-03-21","2022-03-13","2022-03-13","2022-03-13","2022-03-13","2022-03-13","2022-05-21","2022-03-21","2022-05-21","2022-04-22","2022-03-21","2022-05-21","2022-03-21","2022-05-23","2022-03-21","2022-03-21","2022-03-21","2022-03-21","2022-03-21","2022-03-21","2022-03-21","2022-04-22","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-05-24","2022-05-24","2022-05-26","2022-05-23","2022-05-26","2022-05-26","2022-05-26","2022-05-26","2022-06-13","2022-06-28","2022-05-23","2022-11-16","2022-11-16","2022-11-16"],"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":[["","10702000610","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","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":""}]}]}