{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARRICK CRAYTON","gend":0,"add":"1195 OLD INDIAN ROAD","city":"BRODNAX","state":"VA","zip":"23920-9998","dob":"1966-01-31","age":"","mstatus":"","insh":"5084636*01","cliId":"","pno":"434\/532-9293","cno":"","email":"","ename":"","eno":"","pphy":"POWERS III, GRAHAM H 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":["R07.9","R51.","R52.","K65.4","I10.","E83.42","E11.40","Z68.32","M86.149","H53.9","N18.3","E11.9","E78.2","R10.9","R11.10","R25.2","R60.0","M79.604","M79.605","E11.3511","E11.3512","H35.82","H35.033","R10.32","M25.552","R06.02","R79.1","I12.9","E11.22","I48.91","E78.5","Z87.891","N18.9","I13.0","I50.33","E87.70","N17.9","L03.115","K76.89","NO DATA","I25.10","Z91.19","E66.9","M79.3","Z79.4","E11.49","Z68.35","E11.3499","I70.0","I50.32","E11.42","E11.29","R14.0","E11.319","R06.00","L03.90","R06.83","R68.2","R44.3","H40.013","R10.84","L02.511","M86.141","E11.21","M10.9","Z68.31","E11.3411","E11.3412","E11.3519","M79.661","M79.662","K85.90","H40.9","K21.9","E11.43","F17.210","K52.9","E11.65","K31.84","D64.9","N28.9","K08.89","N18.30","Z20.828","Z68.33","Z68.34","I42.8","I48.0","K57.90","G89.29","E11.39","H42.","I20.8","R06.09","G47.33","R07.89","I50.30","I27.20","Z79.899","K59.00","R11.0","R12.","S92.411A","M79.674","V54.16","I50.20","R03.0","I50.9","R93.5","D12.5","N18.4","D68.69","R10.13","G62.89","G44.009","I35.8","E87.2","G47.00","R60.9","N19.","L03.019","Z82.49","I20.9","M79.672","M79.671","M79.89","L03.113","S60.511A","L08.9","M65.9","E11.3513","H25.13","H35.013","S80.811A","S83.91XA","W19.XXXA","R10.30","H43.391","H53.141","R20.0","R22.41","M79.641","R10.33","Z86.79","E86.0","G43.909","L03.012","M79.645","Z79.82","Z79.02","J01.00","Z11.59","Z68.37","Z20.822","I21.3","R09.02","R22.40","Z87.81","I51.7","E11.3293","R06.03","M79.642","R20.2","R53.83","M54.9","Z23.","R51.9","R22.43","M54.5","R80.8","I50.22","K64.8","K29.50","K29.00","Z79.01","R94.8","L03.011","R10.12","R31.21","E11.3491","E87.1","L03.114","F32.9","M67.40","H66.91","E87.5","Z87.2","I11.0","M90.80","D63.1","E55.9","D50.8","I15.8","E88.9","S61.212A","Z45.2","Z79.2","Z79.1","Z91.81","Z68.30","R68.83","D72.829","I13.10","N39.0","Z71.2","R70.0","G90.09","K57.92","F41.9","Z91.14","Z04.9","M70.32","Z87.442","K59.03","Z86.718","B34.9","K86.1","R41.82","G93.41","I50.41","M79.602","M16.11","I51.9","M54.2","M50.30","K92.1","I16.0","M19.012","R05.9","G62.9","R13.10","M54.12","G45.9","N18.6","Z53.21","I25.2","S42.482A","M25.522","M79.622","R55.","M25.551","I13.2","N18.5","Z76.82","M19.011","U07.1","M25.511","Z01.810","Z13.31","J02.9","J03.90","Z83.3","R42.","R53.1","R31.9","F10.20","E86.9","R94.31","Z91.014","I63.9","R41.0","I95.9","R29.810","R47.81","M79.603","M79.606","I50.21","R26.81","I50.23","I49.5","E87.6","M62.81","Z01.818"],"date":["2022-10-29","2020-08-01","2019-02-17","2022-03-23","2022-10-29","2022-10-29","2022-03-23","2021-12-08","2019-03-29","2019-03-19","2020-09-24","2022-10-09","2022-07-28","2022-10-09","2019-06-27","2019-07-09","2022-09-13","2021-11-08","2021-02-18","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2022-10-09","2019-11-29","2022-09-13","2020-02-19","2022-07-28","2022-09-27","2022-10-09","2022-09-09","2022-10-09","2022-09-27","2022-09-27","2022-04-05","2022-10-26","2022-09-12","2020-10-15","2020-10-15","2022-09-27","2022-03-22","2021-02-24","2022-09-09","2020-12-15","2022-10-29","2022-07-28","2022-09-09","2020-12-15","2022-02-02","2022-10-29","2022-09-09","2022-01-17","2022-08-12","2022-07-05","2022-08-12","2021-03-02","2021-05-27","2021-05-27","2021-05-27","2021-10-04","2022-02-14","2019-02-06","2019-02-06","2022-10-26","2022-03-23","2022-01-14","2019-05-30","2020-03-17","2022-07-28","2019-07-09","2019-07-09","2022-02-02","2020-08-01","2022-10-29","2022-09-09","2019-09-28","2022-01-14","2022-03-01","2021-02-20","2019-09-28","2020-10-15","2020-06-28","2020-10-15","2022-06-08","2022-07-28","2022-03-09","2020-11-12","2022-09-09","2020-11-12","2022-07-09","2020-11-12","2020-11-12","2020-11-13","2020-11-13","2022-07-28","2022-08-12","2022-09-15","2021-07-06","2021-07-06","2022-01-26","2022-02-02","2022-01-28","2021-11-08","2021-11-08","2021-11-16","2021-11-08","2022-02-16","2022-10-09","2021-12-08","2021-12-08","2022-10-29","2022-07-28","2021-10-10","2019-08-15","2020-01-05","2022-09-09","2022-09-15","2020-04-29","2022-10-26","2020-08-14","2020-10-08","2020-11-12","2020-11-12","2021-02-20","2021-10-16","2022-03-09","2021-02-24","2021-02-26","2021-02-26","2021-03-01","2022-10-28","2022-07-01","2021-10-28","2021-06-28","2021-06-28","2021-06-28","2021-08-19","2021-10-28","2021-10-28","2022-08-12","2021-10-16","2019-05-20","2019-06-04","2020-08-01","2022-01-20","2020-08-01","2020-10-05","2020-10-05","2022-01-05","2020-10-13","2020-12-08","2021-01-09","2021-02-17","2022-10-09","2021-07-15","2021-07-15","2021-11-08","2021-11-08","2022-01-21","2019-03-05","2020-02-17","2020-02-27","2020-02-27","2020-02-27","2020-03-16","2020-09-24","2022-09-09","2020-10-13","2021-01-20","2022-10-26","2021-06-03","2021-12-08","2021-12-08","2021-12-08","2022-10-29","2021-12-08","2019-02-05","2022-02-16","2020-03-17","2020-03-17","2022-01-26","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2022-01-26","2021-03-18","2022-10-09","2022-10-26","2022-09-12","2021-12-22","2021-12-22","2022-03-23","2022-10-26","2019-02-01","2019-02-01","2019-02-01","2019-02-01","2019-02-01","2019-05-24","2020-08-01","2020-08-01","2020-08-01","2022-10-09","2020-08-26","2019-03-13","2022-06-11","2019-08-29","2019-08-29","2020-05-27","2022-09-09","2021-02-24","2021-02-24","2022-02-14","2022-01-14","2022-01-20","2022-03-15","2022-03-04","2022-03-01","2022-03-22","2022-03-09","2022-07-19","2022-09-09","2022-09-20","2022-09-20","2022-01-04","2022-04-11","2022-05-24","2022-08-12","2022-09-22","2022-09-22","2022-09-22","2022-09-22","2022-10-06","2022-01-02","2022-03-02","2022-03-07","2022-03-07","2022-03-07","2022-03-23","2022-06-28","2022-09-09","2022-07-05","2022-07-05","2022-07-09","2022-06-11","2022-07-09","2022-10-06","2022-02-09","2022-11-12","2022-04-17","2022-08-12","2022-09-09","2022-09-09","2022-10-09","2022-01-26","2022-09-09","2022-06-09","2022-02-14","2022-03-01","2022-03-01","2022-09-09","2022-03-01","2022-03-01","2022-03-06","2022-03-06","2022-04-05","2022-06-09","2022-09-13","2022-04-11","2022-09-12","2022-09-12","2022-10-25"],"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":[["","","PANTOPRAZOLE"," PANTOPRAZOLE ","60","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","7","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","2","Select","Select",""],["","","ISOSORB","TAB 30MG ER","","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","1","Select","Select",""],["","76385011150","CARVEDILOL","TAB 6.25MG","60","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","","MAG"," MAG ","100","Select","Select",""],["","98302014059","COMFORT","MIS 32GX4MM","300","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","","BD  PEN NEEDL","MIS 32GX4MM","","Select","Select",""],["","16571041110","CIPROFLOXACN","TAB 250MG","5","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","28","Select","Select",""],["","55289091810","BISACODYL","TAB 5MG EC","10","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","6","Select","Select",""],["","00121457706","LACTULOSE","SOL 10GM\/15","500","Select","Select",""],["","","ALPHAGAN"," ALPHAGAN ","5","Select","Select",""],["","","LANTUS"," LANTUS ","15","Select","Select",""],["","50742026201","NIFEDIPINE","TAB 90MG ER","90","Select","Select",""],["","","TORSEMIDE","TAB 20MG","","Select","Select",""],["","23155000301","HYDRALAZINE","TAB 50MG","90","Select","Select",""],["","70710120901","ALLOPURINOL","TAB 100MG","90","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","90","Select","Select",""],["","","ELIQUIS","TAB 5MG","","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","20","Select","Select",""],["","98302000105","ALCOHOL","PAD ","300","Select","Select",""],["","","LISINOPRIL"," LISINOPRIL ","30","Select","Select",""],["","","SODIUM","TAB 10GR","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","","CVS","MIS 30G","","Select","Select",""],["","00254200801","COLCHICINE","TAB 0.6MG","3","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","16","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","","BUMETANIDE","TAB 0.5MG","","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","20","Select","Select",""],["","68382003416","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0","Select","Select",""],["","69842031278","8HR","TAB 650MG","20","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","42","Select","Select",""],["","58914060120","PYLERA","CAP ","120","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","","CLOTRIM\/BETA","CRE DIPROP","","Select","Select",""],["","","XARELTO","TAB 15MG","","Select","Select",""],["","","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","","BUT\/APAP\/CAF","CAP ","","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","100","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","","METOPROL","TAB 25MG","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","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":""}]}]}