{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOROTHY S MILLNER","gend":1,"add":"199 PINE HAVEN DR","city":"LYNCHBURG","state":"VA","zip":"24502-9998","dob":"1951-03-03","age":"","mstatus":"","insh":"900038812*01","cliId":"","pno":"434\/942-1769","cno":"434\/229-2106","email":"","ename":"","eno":"","pphy":"KELLY, JOHN MD","ppno":"434\/534-6868","pcpadd":"1088 LONDON LINKS DR","pcpcity":"FOREST","pcpstate":"VA","pcpzip":24551,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/534-8808","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.2","M47.812","M54.12","M50.30","M48.02","S32.052A","M25.512","M19.012","S32.059A","M51.36","M47.816","M51.26","I10.","M12.812","Z98.890","S46.812D","M50.31","R20.2","Z20.828","Z00.00","Z12.39","Z13.1","E78.5","R73.03","Z23.","Z13.6","M47.896","G47.00","G80.9","Z76.0","M81.0","Z85.3","Z96.653","F32.9","B02.9","M25.612","M62.81","M19.90","M25.511","G89.18","Z12.11","S32.050A","S40.012A","M54.5","S43.82XD","Z01.812","E66.9","Z68.34","B37.2","S46.012D","J98.4","Z96.611","Z47.1","Z96.612"],"date":["2020-09-14","2020-12-28","2020-12-28","2020-12-28","2020-12-28","2021-04-19","2021-08-04","2021-11-19","2021-06-03","2021-06-03","2021-06-03","2021-06-03","2021-08-12","2021-11-19","2021-11-19","2021-11-19","2020-08-21","2020-08-07","2021-01-05","2021-06-24","2021-06-24","2021-06-24","2021-08-12","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-06-24","2021-08-12","2021-06-24","2021-08-12","2021-08-12","2021-08-12","2021-08-12","2021-08-12","2021-08-04","2021-08-04","2021-08-12","2021-08-12","2021-08-12","2021-05-23","2021-04-19","2021-04-19","2021-04-19","2021-08-27","2021-07-06","2021-07-23","2021-07-23","2021-01-05","2021-07-06","2021-07-29","2021-07-29","2021-08-12","2021-08-12"],"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":[]}]},{"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":[["","68382005105","MELOXICAM ","15MG","90","Select","Select",""],["","62037056005","POTASSIUM CHLORIDE ER ","10MEQ ER","90","Select","Select",""],["","50111043301","TRAZODONE HYDROCHLORIDE ","50MG","90","Select","Select",""],["","00781286810","OMEPRAZOLE ","20MG DR","180","Select","Select",""],["","68645051054","HYDROCHLOROTHIAZIDE ","25MG","90","Select","Select",""],["","16714068403","SIMVASTATIN ","40MG","90","Select","Select",""],["","16571020150","DICLOFENAC SODIUM DR ","75MG DR","60","Select","Select",""],["","69097084507","CYCLOBENZAPRINE HYDROCHLORIDE ","5MG","30","Select","Select",""],["","72205001390","PREGABALIN ","75MG","60","Select","Select",""],["","49281012065","FLUZONE HIGH-DOSE PF 2020-2021 ","PF 20-21","1","Select","Select",""],["","51672127502","CLOTRIMAZOLE ","1%","60","Select","Select",""],["","49884016111","CALCITONIN SALMON ","200\/ACT","4","Select","Select",""],["","57664037713","TRAMADOL HCL ","50MG","-28","Select","Select",""],["","59746033790","LOSARTAN POTASSIUM\/HYDROCHLOROTHIAZIDE ","50-12.5","30","Select","Select",""],["","69918030130","TRANEXAMIC ACID ","650MG","3","Select","Select",""],["","49035023801"," ","","100","Select","Select",""],["","00406051201","OXYCODONE\/ACETAMINOPHEN ","5-325MG","28","Select","Select",""],["","49035007814","EQ STOOL SOFTENER ","SOFTENER","100","Select","Select",""],["","57237007810","ONDANSETRON ODT ","8MG ODT","10","Select","Select",""],["","70677003402","SM STOOL SOFTENER ","100MG","100","Select","Select",""],["","49281012165","FLUZONE HIGH-DOSE PF 2021-2022 ","2021-22","1","Select","Select",""],["","42806040021","METHYLPREDNISOLONE DOSE PACK ","4MG","21","Select","Select",""],["","69452014430","BENZONATATE ","200MG","30","Select","Select",""],["","31722099601","HYDROCODONE BITARTRATE\/ACETAMINOPHEN ","5-325MG","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":["",""]}},{"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":""}]}]}