{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   REGORROLYAT L","gend":0,"add":"UD 025NL YTS","city":"CHILHOWIE","state":"VA","zip":"24319-9998","dob":"1940-06-19","age":"","mstatus":"","insh":"05000910*995","cliId":"","pno":"46\/6723848-6","cno":"","email":"","ename":"","eno":"","pphy":"TAYLOR, JENNIFER NP","ppno":"276\/258-3780","pcpadd":"16000 JOHNSTON MEMORIAL DR","pcpcity":"ABINGDON","pcpstate":"VA","pcpzip":24210,"pcpcounty":"","pcpid":"","pcpname":"BLUE RIDGE MEDICAL MANAGEMENT CORPORATION","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP ","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.40","E11.3291","Z79.84","I10.","E53.8","Z79.891","H35.3131","E11.9","E11.65","E78.2","R20.0","Z79.4","Z79.899"],"date":["2022-09-27","2022-09-12","2022-09-12","2022-09-12","2022-04-25","2022-04-25","2022-06-01","2022-06-01","2022-09-27","2022-05-09","2022-05-09","2022-05-09","2022-05-09"],"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":[["","65862047705","RAMIPRIL","CAP 10MG","180","Select","Select",""],["","00143962125","CYANOCOBALAM","INJ 1000MCG","3","Select","Select",""],["","68382000105","PAROXETINE","TAB 40MG","90","Select","Select",""],["","72888001101","BACLOFEN","TAB 20MG","270","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","180","Select","Select",""],["","68382032001","POT  CHLORIDE","TAB 10MEQ ER","35","Select","Select",""],["","60505003306","PENTOXIFYLLI","TAB 400MG ER","270","Select","Select",""],["","00378718705","METFORMIN","TAB 1000MG","180","Select","Select",""],["","69452020720","CALCITRIOL","CAP 0.25MCG","90","Select","Select",""],["","45963055650","GABAPENTIN","CAP 300MG","270","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","00067067430","LORATADINE","TAB 10MG","90","Select","Select",""],["","49281012265","FLUZONE","INJ 2022-23","1","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","42","Select","Select",""],["","00169266015","TRESIBA","INJ 100UNIT","30","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","90","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":""}]}]}