{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MURRAY FINE","gend":0,"add":"130 HOUSTON ST APT 101","city":"LEXINGTON","state":"VA","zip":"24450-9998","dob":"1961-01-12","age":"","mstatus":"","insh":"20051237*01","cliId":"","pno":"540\/817-9491","cno":"","email":"","ename":"","eno":"","pphy":"MARSH, JOHN O MD","ppno":"540\/887-2627","pcpadd":"40 CHERRY GROVE ROAD","pcpcity":"MIDDLEBROOK","pcpstate":"VA","pcpzip":24459,"pcpcounty":"","pcpid":"","pcpname":"PRIVIA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/886-2726","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R00.1","R55.","G40.909","I10.","N17.9","S59.912A","S61.511A","S19.9XXA","S41.112S","M06.221","Z68.27","F17.210","F41.1","M10.09","F10.129","M54.2","R94.31","Z45.09","Z00.00","E78.2","N40.0","Z12.5","Z23.","A69.22","S51.812A","S61.412A","L03.114","R69.","I49.8","S49.91XA","F10.929","J44.9","I25.2","NO DATA","G62.9","F10.10","L03.119","F10.20","S09.93XA","I95.9","R25.1","I65.22","G40.409","F17.200","E87.5","S69.90XA","F10.120","L03.90","T14.8XXA","M79.601","E66.9","R41.89","W19.XXXA","S63.501A","R56.9","L03.113","R42.","T14.90XA","J44.1","R06.02","R58.","J20.9","L03.116","S51.811A","F10.920","M25.532","H57.9","F32.9","R27.0","E78.5","Z95.5","I25.10","R07.9","R04.0","M79.10","S01.81XA","R25.9","I65.23","G60.9","R07.89","R53.1","S81.811A","L03.115","V58.89","F41.9","E66.3","R06.00","E86.0","R22.31","M25.579","H61.21","Z12.11","G89.4","E11.40","R03.0","J96.01","J96.02","I50.33","I50.9","I11.0","Z20.822","R60.0","I45.81","I51.7"],"date":["2021-06-13","2022-05-16","2022-10-27","2022-10-27","2021-06-15","2021-03-19","2021-03-19","2021-03-19","2021-05-03","2021-06-18","2021-06-24","2022-04-05","2022-10-27","2021-06-24","2021-07-13","2021-07-13","2022-04-05","2022-03-10","2022-07-26","2022-10-27","2022-10-27","2022-07-26","2020-09-10","2020-09-10","2021-03-19","2021-04-02","2021-04-12","2021-06-21","2020-09-24","2021-01-03","2021-01-03","2022-10-27","2021-03-22","2022-10-27","2022-07-26","2021-03-22","2021-04-01","2022-05-16","2021-06-13","2021-06-13","2021-12-14","2021-12-14","2020-05-23","2022-07-26","2022-07-26","2020-06-30","2021-07-13","2021-02-23","2021-02-10","2021-02-10","2021-02-10","2021-08-02","2021-08-02","2020-06-30","2022-04-06","2021-02-17","2021-08-02","2021-08-02","2022-04-06","2022-04-05","2020-05-22","2020-12-18","2020-12-18","2021-01-03","2021-01-03","2021-03-22","2021-06-13","2021-06-14","2021-06-14","2022-04-06","2021-06-14","2022-04-06","2020-05-22","2020-05-22","2021-06-24","2021-07-13","2019-03-19","2019-06-03","2019-06-03","2022-04-05","2019-10-07","2019-07-29","2019-09-09","2019-08-05","2019-08-05","2019-10-07","2022-04-05","2019-10-07","2019-10-14","2019-02-25","2019-09-09","2019-09-09","2022-07-26","2022-10-27","2022-03-10","2022-04-06","2022-04-06","2022-04-06","2022-04-05","2022-04-05","2022-04-05","2022-10-27","2022-07-26","2022-04-06"],"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":[["","","METOPROL"," METOPROL ","60","Select","Select",""],["","","LEVETIRACETA","TAB 500MG","","Select","Select",""],["","","PREGABALIN","CAP 150MG","","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","180","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","68462026390","ROSUVASTATIN","TAB 20MG","30","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","3","Select","Select",""],["","65162036110","FOLIC","TAB 1MG","30","Select","Select",""],["","","CLOPIDOGREL"," CLOPIDOGREL ","30","Select","Select",""],["","","CITALOPRAM"," CITALOPRAM ","30","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","90","Select","Select",""],["","53746010905","HYDROCO\/APAP","TAB 5-325MG","7","Select","Select",""],["","","AMANTADINE"," AMANTADINE ","60","Select","Select",""],["","16714007701","TADALAFIL","TAB 20MG","30","Select","Select",""],["","68382032001","POT  CHLORIDE","TAB 10MEQ ER","90","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","59746017506","PREDNISONE","TAB 20MG","13","Select","Select",""],["","51224002230","AZITHROMYCIN","TAB 250MG","2","Select","Select",""],["","68645052254","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00378932132","WIXELA","AER 250\/50","180","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","60505016909","PRAVASTATIN","TAB 20MG","30","Select","Select",""],["","57664037713","TRAMADOL","TAB 50MG","15","Select","Select",""],["","49100040012","CULTURELLE","CAP DIGESTIV","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","08327030909","SILVASORB","GEL ","44","Select","Select",""],["","00536468010","VITAMIN","TAB 100MG","30","Select","Select",""],["","40093010588","B-1","TAB 100MG","30","Select","Select",""],["","60793041130","FLECTOR","DIS 0.013","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00071101668","LYRICA","CAP 150MG","60","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","","PROMETH\/COD","SOL 6.25-10","","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":""}]}]}