{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID C NEIGHBORS","gend":0,"add":"5485 BISHOP CREEK RD","city":"LYNCH STATION","state":"VA","zip":245719999,"dob":"1954-09-08","age":"","mstatus":"","insh":11008434,"cliId":"5M58D90GF30","pno":5407073035,"cno":"","email":"","ename":"","eno":"","pphy":"ALBERS, GREGG","ppno":4348468421,"pcpadd":"2811 Linkhorne Dr Ste A","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245033354,"pcpcounty":"","pcpid":"P9307470","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"WESTERN\/CHARLOTTESVILLE","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["H90.3","J35.8","J34.2","G47.33","H61.23","B35.1","E11.42","L60.3","L84","R39.81","Z99.3","M86.162","S88.112D","R53.81","E78.5","E11.9","I10","J44.9","F03.90","S61.409A","Z87.891","F43.29","Z51.5","Z20.828","Z68.41","E87.1","J96.11","F33.2","I50.30","E66.01","M19.90","Z66","K31.84","I11.0","K22.2","R09.89","J98.8","B02.9","R06.83","H61.20","H91.90","R40.4","E11.3293","H25.13","E11.65","I73.9","I48.0","F32.9","Z89.512","Z86.711","Z91.81","R53.1","G30.0","F02.81","E11.59","G31.09","F02.80","Z79.4","I69.391","M79.669","I63.9","M79.674","D64.9","Z79.899","Z20.822","I50.9","R26.2","R27.8","F33.1","F41.1","F91.8","F43.21","R09.02","R11.11","R05","L97.929","F03.91","Z89.519","Z68.30","R46.89","Z71.89","K22.9","I26.99"],"date":["2020-01-13","2020-02-13","2020-01-13","2020-12-01","2020-01-13","2020-01-24","2020-01-24","2020-01-24","2020-01-24","2020-11-01","2020-11-01","2020-03-18","2020-03-18","2020-10-27","2021-01-13","2021-04-02","2021-04-02","2021-05-01","2020-12-01","2020-10-05","2020-10-05","2020-11-16","2020-11-13","2021-01-20","2020-11-02","2020-12-01","2020-12-01","2020-11-16","2021-05-01","2020-12-08","2020-11-02","2020-11-02","2020-12-01","2020-12-01","2020-11-09","2020-11-03","2019-12-23","2019-11-08","2019-11-08","2019-11-08","2019-11-08","2020-11-09","2019-11-11","2019-11-11","2021-05-01","2021-05-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-11-26","2020-11-26","2020-11-26","2021-04-05","2020-12-08","2020-12-08","2020-12-03","2021-03-06","2021-03-03","2021-04-02","2021-04-03","2021-01-13","2021-01-13","2021-01-18","2020-12-11","2021-05-01","2021-05-01","2021-06-23","2021-06-23","2021-06-23","2021-06-18","2020-11-02","2020-11-02","2020-11-02","2021-05-27","2020-11-11","2020-11-02","2020-11-02","2020-11-16","2020-11-11","2020-11-13","2020-11-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","99073070827","FREESTYLE","TES LITE","","Select","Select",""],["","29300017116","MEMANTINE","TAB HCL 5MG","","Select","Select",""],["","65862076990","FENOFIBRATE","TAB 145MG","","Select","Select",""],["","16714074703","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","50458057990","XARELTO","TAB 20MG","","Select","Select",""],["","43547028210","ESCITALOPRAM","TAB 20MG","","Select","Select",""],["","69097017353","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","","Select","Select",""],["","68180044601","QUETIAPINE","TAB 50MG","","Select","Select",""],["","73070010315","INSULIN ASPA","INJ FLEXPEN","","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","68180012101","CEPHALEXIN","CAP 250MG","","Select","Select",""],["","2879959","HUMALOG KWIK","INJ 100\/ML","","Select","Select",""],["","69097094505","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","2771559","BASAGLAR","INJ 100UNIT","","Select","Select",""],["","169633910","NOVOLOG","INJ FLEXPEN","","Select","Select",""],["","88221905","LANTUS SOLOS","INJ 100\/ML","","Select","Select",""],["","169183302","NOVOLIN R","INJ RELION","","Select","Select",""],["","2822259","INSULIN LISP","INJ 100\/ML","","Select","Select",""],["","185067401","HYDROXYZ PAM","CAP 25MG","","Select","Select",""],["","143928501","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","49281040565","FLUZONE HD","INJ PF 19-20","","Select","Select",""],["","72205000399","ROSUVASTATIN","TAB 10MG","","Select","Select",""],["","57664050658","METOPROL ","TAB 25MG","60","Select","Select",""],["","29300017116","MEMANTINE ","TAB HCL 5MG","30","Select","Select",""],["","169633910","NOVOLOG ","INJ FLEXPEN","15","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","400","Select","Select",""],["","16714074102","FENOFIBRATE ","CAP 200MG","90","Select","Select",""],["","50458057990","XARELTO ","TAB 20MG","90","Select","Select",""],["","16714074703","OMEPRAZOLE ","CAP 20MG","180","Select","Select",""],["","43547028210","ESCITALOPRAM ","TAB 20MG","180","Select","Select",""],["","69097094505","ATORVASTATIN ","TAB 20MG","14","Select","Select",""],["","69097017353","IPRATROPIUM\/ ","SOL ALBUTER","90","Select","Select",""],["","59762330403","NITROGLYCERN ","SUB 0.4MG","25","Select","Select",""],["","68180044601","QUETIAPINE ","TAB 50MG","28","Select","Select",""],["","72205000399","ROSUVASTATIN ","TAB 10MG","30","Select","Select",""],["","73070010315","INSULIN ","INJ FLEXPEN","15","Select","Select",""],["","68180012101","CEPHALEXIN ","CAP 250MG","20","Select","Select",""],["","2771559","BASAGLAR ","INJ 100UNIT","15","Select","Select",""],["","88221905","LANTUS ","INJ 100\/ML","15","Select","Select",""],["","2879959","HUMALOG ","INJ 100\/ML","3","Select","Select",""],["","169183302","NOVOLIN ","INJ RELION","10","Select","Select",""],["","185067401","HYDROXYZ ","CAP 25MG","40","Select","Select",""],["","143928501","AMOXICILLIN ","875MG","20","Select","Select",""],["","49281040565","FLUZONE ","PF 19-20","0.5","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}