{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARRY   L TAYLOR","gend":0,"add":"260 EASTWOOD DR LOT 8","city":"DANVILLE","state":"VA","zip":"24540-9998","dob":"1967-08-24","age":"","mstatus":"","insh":"20035984*01","cliId":"","pno":"434\/791-2089","cno":"","email":"","ename":"","eno":"","pphy":"TRIPATHI, KAVITA MD","ppno":"434\/791-1345","pcpadd":"125 EXECUTIVE DRIVE #H","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":24541,"pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/799-6865","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.571","M19.071","E66.3","I10.","E78.5","E11.40","E53.8","M17.11","Z23.","M17.5","E11.9","E55.9","NO DATA","Z12.11","Z12.5","M79.671","E11.42","V58.89","Z51.81","K04.7","F17.210","M10.9","R22.0","R68.89","J01.90","D64.9","K02.9","Z28.3","K21.9","I11.9","M1A.00X0","Z11.59","B35.1","B35.3","Z79.899","M20.5X1","M79.672","M20.12","E79.0","M25.50"],"date":["2020-09-14","2020-09-14","2020-08-17","2022-10-19","2022-10-19","2022-10-19","2020-04-22","2021-05-26","2022-10-19","2021-05-12","2022-10-19","2022-10-19","2021-11-17","2022-10-19","2022-06-30","2022-09-01","2022-06-30","2021-12-29","2022-03-30","2019-09-17","2019-09-17","2022-04-28","2019-09-17","2019-03-13","2019-03-13","2019-03-13","2019-09-17","2022-03-30","2022-04-28","2022-06-30","2022-06-30","2022-06-30","2022-09-01","2022-06-30","2022-03-30","2022-09-01","2022-09-01","2022-09-01","2022-10-19","2022-10-19"],"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":[["","00002223680","TRULICITY","INJ 3\/0.5","6","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","90","Select","Select",""],["","65162003416","OMEGA-3-ACID","CAP 1GM","120","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","53885027150","ONETOUCH","TES VERIO","50","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","00169413013","OZEMPIC","INJ 4MG\/3ML","3","Select","Select",""],["","65862076990","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","60505014202","GLIPIZIDE","TAB 10MG","180","Select","Select",""],["","00597015337","JARDIANCE","TAB 25MG","90","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","16729013516","ALLOPURINOL","TAB 300MG","90","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","00472037915","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","7","Select","Select",""],["","00054050823","ICOSAPENT","CAP 1GM","120","Select","Select",""],["","52937000120","VASCEPA","CAP 1GM","120","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","00310654004","BYDUREON","INJ 2\/0.85ML","1","Select","Select",""],["","37205041878","PEN  NEEDLES","MIS 31GX5\/16","100","Select","Select",""],["","00006008061","JANUMET","TAB 50-1000","60","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","00527133001","BACLOFEN","TAB 10MG","30","Select","Select",""],["","68382039801","POT  CHLORIDE","TAB 20MEQ ER","5","Select","Select",""],["","00904598660","VITAMIN","CAP 5000UNIT","30","Select","Select",""],["","69097096507","NABUMETONE","TAB 500MG","60","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}