{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACOB   P SAWYER","gend":0,"add":"2246 WINDOM PL","city":"VIRGINIA BEACH","state":"VA","zip":"23454-9998","dob":"1998-03-19","age":"","mstatus":"","insh":"1111101*03","cliId":"","pno":"252\/339-0706","cno":"252\/339-0706","email":"","ename":"","eno":"","pphy":"WOODARD, ROBERT M MD","ppno":"757\/481-2333","pcpadd":"1120 FIRST COLONIAL RD STE 101","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":210216,"pcpname":"Privia - First Colonial Family Practice","plan":"OHP","program":"ACA","lob":"Small Group","region":"TIDEWATER","aligned":"","ano":"757\/340-6860","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/481-1037","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F90.2","F39.","F42.9","F32.9","F50.81","F90.1","Z51.81","Z20.2","Z23.","Z83.49","F31.9","F60.5","K76.0"],"date":["2020-01-04","2020-10-29","2021-09-23","2021-09-23","2021-06-24","2021-06-24","2021-06-24","2021-04-19","2021-09-03","2020-10-06","2020-01-15","2020-01-15","2021-06-24","2021-09-03"],"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":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","61958070101","TRUVADA","200-300","30","Select","Select",""],["","13107007001","AMPHET\/DEXTR","10MG","30","Select","Select",""],["","59417010410","VYVANSE","40MG","30","Select","Select",""],["","65862019430","FLUOXETINE","40MG","60","Select","Select",""],["","62756018588","OXCARBAZEPIN","600MG","60","Select","Select",""],["","29300014801","QUETIAPINE","50MG","90","Select","Select",""],["","68180031906","BUPROPN","150MG XL","30","Select","Select",""],["","43547028910","BUPROPION","150MG SR","30","Select","Select",""],["","00093760756","EMTR\/TENOFOV","200-300","-30","Select","Select",""],["","51672413101","LAMOTRIGINE","100MG","60","Select","Select",""],["","00228284803","FLUVOXAMINE","100MG ER","30","Select","Select",""],["","88888888887","DMR","","1","Select","Select",""],["","43598016630","OLANZAPINE","10MG","-30","Select","Select",""],["","61958070101","TRUVADA ","200-300","30","Select","Select",""],["","65862019430","FLUOXETINE ","40MG","60","Select","Select",""],["","29300014801","QUETIAPINE ","50MG","90","Select","Select",""],["","62756018588","OXCARBAZEPIN ","600MG","60","Select","Select",""],["","59417010410","VYVANSE ","40MG","-30","Select","Select",""],["","13107007001","AMPHET\/DEXTR ","10MG","30","Select","Select",""],["","68180031906","BUPROPN ","150MG XL","30","Select","Select",""],["","43547028910","BUPROPION ","150MG SR","30","Select","Select",""],["","00093760756","EMTR\/TENOFOV ","200-300","-30","Select","Select",""],["","51672413001","LAMOTRIGINE ","25MG","60","Select","Select",""],["","88888888887","DMR ","","1","Select","Select",""],["","43598016630","OLANZAPINE ","10MG","30","Select","Select",""],["","00228284803","FLUVOXAMINE ","100MG ER","30","Select","Select",""],["","65862052890","VENLAFAXINE ","75MG ER","30","Select","Select",""],["","65862052890","VENLAFAXINE","75MG ER","30","Select","Select",""],["","59148003613","REXULTI ","TAB 0.5MG","30","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","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":""}]}]}