{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHNNIE M MCKNIGHT-HARRIS","gend":1,"add":"807 WESTOVER AVE","city":"SOUTH HILL","state":"VA","zip":"23970-9998","dob":"1963-11-29","age":"","mstatus":"","insh":"11003027","cliId":"","pno":4342621458,"cno":4347557949,"email":"","ename":"","eno":"","pphy":"POWERS, GRAHAM H","ppno":4345842000,"pcpadd":"200 E 5th St","pcpcity":"Chase City","pcpstate":"VA","pcpzip":239241456,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"807 WESTOVER AVE","madd2":"","madd3":"","mcity":"SOUTH HILL","mstate":"VA","mzip":"23970-9998","pcpfaxno":"(434) 447-2240","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"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":[]},{"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":[["","65162044210","MECLIZINE ","25MG","90.00","Select","Select",""],["","00228202950","ALPRAZOLAM ","0.5MG","90.00","Select","Select",""],["","00093317431","ALBUTEROL ","E HFA INH","8.50","Select","Select",""],["","00054327099","FLUTICASONE ","50MCG","16.00","Select","Select",""],["","65862057490","MONTELUKAST ","10MG","90.00","Select","Select",""],["","00093206301","QUETIAPINE ","25MG","180.00","Select","Select",""],["","00591565810","CYCLOBENZAPR ","10MG","21.00","Select","Select",""],["","00065026025","TRAVATAN ","0.00%","2.50","Select","Select",""],["","55111015810","OMEPRAZOLE ","20MG","90.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","60505059304","TRAVOPROST ","0.00%","7.50","Select","Select",""],["","69097015907","MELOXICAM ","15MG","30.00","Select","Select",""],["","60505265601","TRIAMT\/HCTZ ","37.5-25","90.00","Select","Select",""],["","00115169449","EPINEPHRINE ","0.3MG","2.00","Select","Select",""],["","61314022710","TIMOLOL ","0.5% OP","10.00","Select","Select",""],["","24208029505","TOBRA\/DEXAME ","0.3-0.1%","5.00","Select","Select",""],["","69097094312","GABAPENTIN ","300MG","30.00","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","21.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","30.00","Select","Select",""],["","53746010901","HYDROCO\/APAP ","5-325MG","20.00","Select","Select",""],["","66689000816","NYSTATIN ","100000","200.00","Select","Select",""],["","16571020106","DICLOFENAC ","75MG DR","28.00","Select","Select",""],["","00173071920","FLOVENT ","110MCG","12.00","Select","Select",""],["","31722070530","VALACYCLOVIR ","1GM","21.00","Select","Select",""],["","71930005552","APAP\/CODEINE ","300-30MG","20.00","Select","Select",""],["","66993066330","DULOXETINE ","30MG","30.00","Select","Select",""],["","68180071160","CEFDINIR ","300MG","20.00","Select","Select",""],["","00527133850","DOXYCYC ","100MG","14.00","Select","Select",""],["","33342032915","TRIAMCINOLON ","0.10%","15.00","Select","Select",""],["","00378064205","PREDNISONE ","20MG","10.00","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}