{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARL S FLEMING","gend":0,"add":"123 CHESTER DR SIDE 1","city":"DANVILLE","state":"VA","zip":"24541-9998","dob":"1966-12-31","age":"","mstatus":"","insh":"20051254*01","cliId":"","pno":4347138491,"cno":4347138491,"email":"","ename":"","eno":"","pphy":"JALANDHARA, VINITKUMAR R MD","ppno":4348573600,"pcpadd":"414 PARK AVE,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"Neurology & Sleep Clinic of Southern VA","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4348573601,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R41.0","F05.","F06.2","F41.9","K21.9","F20.9","R41.82","M77.31","F29.","T43.621A","T50.901A","G93.41","N39.0","G93.40","R58.","I95.9","R60.9","M54.9","N20.0","G40.909","R51.9","F32.89","F41.0","G47.09","F41.8","B96.89","A09.","N23.","M25.531","R30.0","T50.904A","T88.7XXA","R23.1","I10.","F33.2","R40.4","R45.6","W19.XXXA","R56.9","NO DATA","S92.301A","S60.221A","S90.31XA","K59.00","R31.9","Z53.20","F17.210","T50.991A","F15.129","F39.","F31.9","F25.9","R82.71","M47.812","I77.810","J98.11","I51.7","Z20.822","Z79.899","R10.9","L08.9","M79.642","L03.012","I89.1","L08.89","B95.62","L03.114","L02.512","M25.442","M79.645","Z98.890","Z53.29","M79.89","Z77.120","G89.18","L03.90","Z48.02","S69.92XA","Y99.9"],"date":["2022-12-23","2022-12-23","2022-12-23","2023-01-19","2023-01-16","2023-08-09","2023-01-18","2023-01-18","2023-01-18","2023-01-18","2022-10-21","2022-12-22","2023-02-06","2022-12-24","2023-01-18","2023-01-18","2023-05-15","2023-02-06","2023-02-06","2022-12-23","2021-04-07","2021-04-07","2021-04-07","2023-05-04","2023-08-09","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2023-02-06","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2022-12-24","2022-12-22","2022-12-22","2022-12-22","2023-08-09","2023-06-22","2023-01-19","2023-01-19","2023-01-19","2023-01-19","2023-02-01","2023-06-07","2022-10-21","2022-10-21","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2022-12-23","2023-02-06","2023-05-14","2023-06-07","2023-05-15","2023-05-15","2023-05-17","2023-05-17","2023-05-16","2023-05-15","2023-05-16","2023-05-21","2023-05-21","2023-05-21","2023-05-21","2023-06-07","2023-05-17","2023-06-22","2023-05-24","2023-06-07","2023-06-07"],"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":[["","69097081507","GABAPENTIN","400 MG","90","Select","Select",""],["","00093083205","CLONAZEPAM","0.5 MG","90","Select","Select",""],["","43547034006","RISPERIDONE","TAB 0.5MG","60","Select","Select",""],["","50428038612","ACETAMINOPHEN","500 MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","30","Select","Select",""],["","69097015807","MELOXICAM","7.5 MG","20","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","00093342210","CYCLOBENZAPRINE HCL","10 MG","20","Select","Select",""],["","00603188016","LIDOCAINE","5 %","30","Select","Select",""],["","70436001102","BUPROPION XL","300 MG","60","Select","Select",""],["","00115180401","HYDROXYZINE PAMOATE","50 MG","60","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","20","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","14","Select","Select",""],["","57237007730","ONDANSETRON ODT","4 MG","10","Select","Select",""],["","45802048678","DOCUSATE SODIUM","100 MG","100","Select","Select",""],["","10702001801","OXYCODONE HCL","5 MG","10","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","28","Select","Select",""],["","69097081507","GABAPENTIN CAP","400MG","15","Select","Select",""],["","00093083205","CLONAZEPAM TAB","0.5MG","180","Select","Select",""],["","43547034006","RISPERIDONE TAB","0.5MG","60","Select","Select",""],["","00093005805","TRAMADOL HCL","50 MG","5","Select","Select",""],["","00093101042","MUPIROCIN","2 %","22","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":""}]}]}