{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JENNIFER   J TAIBBI","gend":1,"add":"1407 BURGESS LN","city":"CHARLOTTESVILLE","state":"VA","zip":"22902-9998","dob":"1982-04-10","age":"","mstatus":"","insh":"20064366*01","cliId":"","pno":"434\/284-3112","cno":"434\/284-3112","email":"","ename":"","eno":"","pphy":"KATZ, MARTIN D MD","ppno":"434\/817-1818","pcpadd":"310 AVON STREET SUITE 9","pcpcity":"CHARLOTTESVILLE","pcpstate":"VA","pcpzip":22902,"pcpcounty":"","pcpid":"","pcpname":"Privia - Downtown Family Health Care, Inc","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/817-9606","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F50.00","F33.1","F41.1","M72.2","F45.42","M54.5","G89.4","M62.838","M25.552","M25.511","M25.571","M25.562","F50.01","N91.1","M92.52","F43.10","I73.00","M79.671","M25.879","M53.3","G89.29","M70.61","M76.821","F41.8","NO DATA","M76.52","Z30.432","M23.8X2","F50.9","F60.3","J02.9","R09.81","R51.9","Z20.822","M99.02","M99.01","Z20.828","K55.069","D72.819","M25.80","R53.83","N91.2","I73.9","F51.04","H66.92","J01.00","B34.9","R71.8","F32.1","S76.012A","M99.03","Z72.821","I82.409","R63.0","F43.9"],"date":["2021-08-23","2021-08-23","2022-03-28","2020-11-30","2021-08-23","2021-09-30","2022-09-15","2021-09-01","2022-07-01","2022-05-13","2022-05-13","2021-05-03","2021-03-15","2020-02-21","2020-08-14","2021-03-15","2020-12-23","2021-05-03","2020-12-23","2021-05-03","2022-02-23","2021-10-25","2022-10-25","2021-07-19","2021-10-15","2020-02-28","2020-02-26","2020-02-27","2020-03-20","2021-04-28","2021-12-24","2021-12-24","2021-12-24","2022-05-17","2020-02-12","2020-02-12","2020-09-27","2020-12-28","2021-12-29","2021-03-09","2021-03-09","2021-12-29","2021-12-29","2021-12-29","2022-10-02","2022-10-02","2020-04-07","2020-08-14","2020-08-14","2021-08-16","2020-05-06","2020-08-10","2020-06-19","2020-06-19","2021-07-13"],"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":[]},{"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":[["","16714017201","TIZANIDINE","TAB 4MG","90","Select","Select",""],["","00555904558","AVIANE","TAB ","28","Select","Select",""],["","43547028211","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","13107008301","LORAZEPAM","TAB 0.5MG","14","Select","Select",""],["","68462041929","HAILEY","TAB 43831","84","Select","Select",""],["","16714008211","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","11527070442","SOD","GEL 1.1-5%","200","Select","Select",""],["","00603020922","MAG","TAB 400MG","180","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","60258017201","MAG-G","TAB 500MG","180","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","60","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","60","Select","Select",""],["","00126002292","PREVDNT","PST 1.1-5%","200","Select","Select",""],["","52817033050","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","00555077902","MEDROXYPR","TAB 10MG","10","Select","Select",""],["","00245010810","FERROUS","TAB 325MG EC","90","Select","Select",""],["","00430042014","LO","TAB 40452","84","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","16714061305","SERTRALINE","TAB 100MG","45","Select","Select",""],["","16714097601","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","25","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","120","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","00406048401","APAP\/CODEINE","TAB 300-30MG","24","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":""}]}]}