{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MEGAN BLACKWELL","gend":1,"add":"509 NOTTOWAY AVE APT 101","city":"BLACKSTONE","state":"VA","zip":"23824-9998","dob":"1986-12-17","age":"","mstatus":"","insh":"20023960*01","cliId":"","pno":"434\/262-1952","cno":"","email":"","ename":"","eno":"","pphy":"POWERS, DAVID C MD","ppno":"434\/584-2025","pcpadd":"514 W ATLANTIC ST","pcpcity":"SOUTH HILL","pcpstate":"VA","pcpzip":23970,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/447-2240","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Q78.2","L70.9","L40.3","L73.2","H40.023","H52.13","H10.45","H40.022","H50.52","L70.0","D22.5","Z22.7","L66.9","E67.3","M25.511","R06.02","NO DATA","M35.9","M94.0","R76.11","R74.0","L98.9","M86.30","E55.9","L65.9","H04.123","R04.2","R05.","J20.9","Z87.09","Z68.32","E66.9","N91.2","N89.8","D31.01","J03.90","B08.5","N92.6","Z11.3","Z30.41","Z79.899"],"date":["2019-05-30","2019-05-30","2021-09-27","2021-09-27","2021-12-21","2021-04-26","2020-12-28","2020-12-28","2020-11-19","2021-09-27","2020-01-13","2021-09-27","2021-09-27","2021-09-27","2019-02-07","2019-02-07","2020-12-28","2019-02-07","2019-02-07","2019-09-25","2019-09-25","2019-09-25","2021-04-12","2021-04-12","2019-12-18","2021-12-21","2020-11-20","2020-11-20","2020-11-20","2020-11-20","2020-11-20","2020-11-20","2021-09-08","2021-09-08","2020-12-28","2019-09-15","2019-09-15","2021-07-02","2021-07-02","2021-07-02","2021-02-01"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","00574232545","TRETINOIN","GEL 0.00025","45","Select","Select",""],["","","NORETH\/ETHIN"," NORETH\/ETHIN ","28","Select","Select",""],["","00187517045","RETIN-A","GEL 0.00025","45","Select","Select",""],["","","BENZOYL"," BENZOYL ","60","Select","Select",""],["","","METHOTREXATE"," METHOTREXATE ","24","Select","Select",""],["","","HUMIRA"," HUMIRA ","4","Select","Select",""],["","","CLINDAMYCIN"," CLINDAMYCIN ","30","Select","Select",""],["","","CLOBETASOL","OIN 0.0005","","Select","Select",""],["","68001024717","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","49348011537","SM","SOL CLNSR 4%","237","Select","Select",""],["","00234057504","HIBICLENS","LIQ 0.04","237","Select","Select",""],["","52380127206","CHLOR","LIQ 0.04","473","Select","Select",""],["","","MICROGESTIN"," MICROGESTIN ","28","Select","Select",""],["","46122013734","SKIN","SOL 0.04","236","Select","Select",""],["","75834002012","VITAMIN","CAP 50000UNT","10","Select","Select",""],["","24208083060","NEO\/POLY\/DEX","SUS 0.1% OP","5","Select","Select",""],["","51672421509","METRONIDAZOL","GEL 0.01","55","Select","Select",""],["","00781711735","CALCIPOTRIEN","CRE 0.00005","60","Select","Select",""],["","","FOLIC"," FOLIC ","30","Select","Select",""],["","","CLEOCIN-T","LOT 0.01","","Select","Select",""],["","","FLUOROMETHOL","SUS 0.1% OP","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","AMOXICILLIN","TAB 875MG","","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":""}]}]}