{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LASHUNDA FRAZIER","gend":1,"add":"40 CANDLEWYCK CT APT 5","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1974-09-19","age":"","mstatus":"","insh":"2166476*01","cliId":"","pno":2767348412,"cno":2767348412,"email":"","ename":"","eno":"","pphy":"HURTADO, RAFAEL MD","ppno":4347923232,"pcpadd":"178 EXECUTIVE DRIVE,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"Neurology & Sleep Clinic of Southern VA","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347923236,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","D86.0","E11.3391","J45.30","H25.13","H43.312","E11.9","M48.02","M54.12","NO DATA","R10.9","R19.7","D86.9","J98.4","N62.","M54.9","G89.29","R42.","E11.3292","Z87.891","Z79.84","M19.072","M19.071","M96.0","M79.672","M79.671","K21.9","G57.91","N17.9","E11.65","R06.02","Z79.52","M15.9","Z51.81","T45.1X5S","R05.9","G57.81","D86.89","Z12.11","K63.5","F17.210","Z86.010","Z80.0","Z00.00","I07.1","Z01.810","R00.1","K58.9","K76.0","R51.9","G47.09","F41.8","F41.0","R23.2","L25.9","L20.9","L72.0","L90.5","G56.01","K58.0","Z11.59","R74.8","M50.30","M50.20","M51.36","M54.16","R20.0","R20.2","G47.10","R63.5","E11.8","E55.9","Z79.899","F32.0","J47.9","M79.604","M25.571","M25.70","E11.42","G93.5","N18.9","D36.13","R01.1","F41.9","M19.90","E66.9","Z68.32","D64.9"],"date":["2023-02-23","2023-04-04","2023-04-04","2022-03-09","2021-08-25","2021-08-25","2022-08-24","2023-02-10","2023-02-10","2023-03-01","2022-05-09","2023-02-23","2023-03-01","2023-01-09","2023-04-04","2023-04-04","2023-04-04","2022-07-26","2022-03-09","2022-03-09","2022-03-09","2021-03-02","2021-03-02","2021-03-02","2021-03-02","2023-02-10","2023-02-22","2022-03-09","2023-02-20","2023-02-20","2023-04-12","2023-02-07","2023-02-07","2023-02-07","2023-02-07","2023-02-07","2022-03-09","2022-07-13","2022-08-24","2022-08-24","2022-08-24","2022-08-24","2022-08-24","2023-02-20","2023-04-12","2022-03-09","2022-03-09","2023-04-11","2023-04-11","2023-04-06","2023-04-06","2023-04-06","2023-04-06","2023-04-06","2022-01-24","2022-01-24","2022-01-24","2022-01-24","2022-03-09","2022-08-10","2023-01-04","2023-01-04","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-02-10","2023-02-22","2023-02-22","2023-02-23","2023-02-23","2022-03-02","2022-03-02","2022-08-22","2022-08-22","2022-08-22","2021-01-15","2021-01-15","2022-08-03","2023-01-12","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09"],"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":[["","64980034214","ALENDRONATE","TAB 70MG","12","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","30","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","70710116701","ATENOL\/CHLOR","TAB 50-25MG","30","Select","Select",""],["","00093005401","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","00591505210","PREDNISONE","TAB 5MG","30","Select","Select",""],["","45963055650","GABAPENTIN","300 MG","90","Select","Select",""],["","67877044730","OLMESA MEDOX","TAB 40MG","90","Select","Select",""],["","68180035202","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00781717612","NALOXONE","SPR ","2","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","180","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","55111032201","GLIMEPIRIDE","4 MG","90","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","60","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","20","Select","Select",""],["","65862001705","AMOXICILLIN","500 MG","56","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","00904698640","MUCUS RELIEF","TAB 600MG ER","30","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","12","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","60505265501","TRAZODONE","TAB 150MG","30","Select","Select",""],["","23155050001","HYDROXYZ HCL","TAB 10MG","60","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","68462010905","TOPIRAMATE","100 MG","60","Select","Select",""],["","65862090801","CELECOXIB","100 MG","60","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","00088221905","LANTUS SOLOS","INJ 100\/ML","9","Select","Select",""],["","42806071501","BENZONATATE","200 MG","60","Select","Select",""],["","00781517501","MYCOPHENOLAT","TAB 500MG","180","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","15","Select","Select",""],["","10702000350","PROMETHAZINE HCL","25 MG","20","Select","Select",""],["","74312033511","BLACK COHOSH","540MG","60","Select","Select",""],["","60505265401","TRAZODONE HCL","100 MG","60","Select","Select",""],["","00002149580","MOUNJARO","5 MG\/0.5ML","2","Select","Select",""],["","00074055402","HUMIRA(CF) PEN","40MG\/0.4ML","2","Select","Select",""],["","16729018929","MYCOPHENOLIC ACID","360 MG","180","Select","Select",""],["","65162055610","TEMAZEPAM","15 MG","30","Select","Select",""],["","31604001882","VITAMIN E","180 MG","60","Select","Select",""],["","00093005401","BUSPIRONE HCL","10 MG","90","Select","Select",""],["","00088221905","LANTUS SOLOSTAR","100\/ML (3)","15","Select","Select",""],["","82607066026","FLOWFLEX COVID-","19 AG HOME TEST","8","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TRIMETHOPRIM","800-160 MG","15","Select","Select",""],["","57599081800","FREESTYLE LIBRE","3 SENSOR","1","Select","Select",""],["","00378668977","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","70710116701","ATENOLOL-CHLORTHALIDONE","50 MG-25MG","90","Select","Select",""],["","23155050201","HYDROXYZINE HCL","50 MG","30","Select","Select",""],["","00781729685","ALBUTEROL SULFATE HFA","90 MCG","6.7","Select","Select",""],["","31604002754","TURMERIC","450MG-50MG","60","Select","Select",""],["","60505082901","FLUTICASONE PROPIONATE","50 MCG","16","Select","Select",""],["","64980034214","ALENDRONATE SODIUM","70 MG","12","Select","Select",""],["","65862022660","CLARITHROMYCIN","500 MG","28","Select","Select",""],["","00591079401","DICYCLOMINE HCL","10 MG","120","Select","Select",""],["","00406055201","OXYCODONE HCL","5 MG","8","Select","Select",""],["","56362000589","IHEALTH COVID-","19 AG HOME TEST","8","Select","Select",""],["","64980034214","ALENDRONATE TAB","70MG","12","Select","Select",""],["","27241009803","DULOXETINE CAP","30MG","30","Select","Select",""],["","67877025145","TRIAMCINOLON CRE","0.1%","454","Select","Select",""],["","00093005401","BUSPIRONE TAB","10MG","90","Select","Select",""],["","70954006020","PREDNISONE TAB","20MG","90","Select","Select",""],["","70710116701","ATENOL\/CHLOR TAB","50-25MG","30","Select","Select",""],["","68462012605","GABAPENTIN TAB","600MG","90","Select","Select",""],["","68462043830","OLMESA MEDOX TAB","40MG","90","Select","Select",""],["","00781717612","NALOXONE SPR","","2","Select","Select",""],["","68180035202","SERTRALINE TAB","50MG","30","Select","Select",""],["","00093216568","NALOXONE HCL SPR","","2","Select","Select",""],["","42858000101","OXYCODONE TAB","5MG","30","Select","Select",""],["","00093314705","CEPHALEXIN CAP","500MG","30","Select","Select",""],["","55111032201","GLIMEPIRIDE TAB","4MG","90","Select","Select",""],["","00527058601","DICYCLOMINE CAP","10MG","60","Select","Select",""],["","68180072003","AMLODIPINE TAB","5MG","180","Select","Select",""],["","00591079501","DICYCLOMINE TAB","20MG","20","Select","Select",""],["","00186037020","SYMBICORT AER","160-4.5","10","Select","Select",""],["","00378668977","PANTOPRAZOLE TAB","40MG","90","Select","Select",""],["","00597015230","JARDIANCE TAB","10MG","90","Select","Select",""],["","00904698640","MUCUS RELIEF TAB","600MG ER","30","Select","Select",""],["","60505082901","FLUTICASONE SPR","50MCG","16","Select","Select",""],["","23155050105","HYDROXYZ HCL TAB","25MG","30","Select","Select",""],["","60505265501","TRAZODONE TAB","150MG","30","Select","Select",""],["","69097014260","ALBUTEROL AER HFA","","7","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","13","Select","Select",""],["","42806040021","METHYLPRED TAB","4MG","21","Select","Select",""],["","57237000511","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","10","Select","Select",""],["","68462015305","TOPIRAMATE TAB","50MG","60","Select","Select",""],["","57237007710","ONDANSETRON TAB","4MG ODT","10","Select","Select",""],["","55111018015","TIZANIDINE TAB","4MG","30","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","15","Select","Select",""],["","65862090801","CELECOXIB CAP","100MG","60","Select","Select",""],["","00088221905","LANTUS SOLOS INJ","100\/ML","9","Select","Select",""],["","00781517501","MYCOPHENOLAT TAB","500MG","180","Select","Select",""],["","42806071501","BENZONATATE CAP","200MG","60","Select","Select",""],["","62037072001","POTASSIUM CHLORIDE","20 MEQ","5","Select","Select",""],["","69547035302","NARCAN","4 MG","2","Select","Select",""],["","55111018015","TIZANIDINE HCL","4 MG","30","Select","Select",""],["","68462043830","OLMESARTAN MEDOXOMIL","40 MG","90","Select","Select",""],["","00406051205","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","00245036030","KLOR-CON","20 MEQ","10","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":""}]}]}