{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BLAKE   T FLYNN","gend":0,"add":"5320 HEADDRESS CT","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1984-07-16","age":"","mstatus":"","insh":"20055342*01","cliId":"","pno":"757\/268-6361","cno":"757\/268-6361","email":"","ename":"","eno":"","pphy":"MATON, BRUNO MD","ppno":"757\/252-9015","pcpadd":"STE 202 301 RIVERVIEW AVE","pcpcity":"NORFOLK","pcpstate":"VA","pcpzip":23510,"pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Neurology Specialists - Heart Hospital","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/510-9041","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F14.90","F10.20","G40.909","F32.9","K04.01","K08.89","S62.337A","W22.8XXA","R63.4","G40.109","Z96.89","R41.3","G93.81","F41.9","F11.24","F15.10","R56.9","R00.0","Z72.0","F33.1","F41.1","T40.491A","F12.90","F19.10","F17.200","Z88.0","Z79.899","G40.802","R94.01","Z98.890","F33.9","T50.901A","T40.601A","R11.2","R51.9","NO DATA","F17.210","Z86.59","Z86.69","Z96.82","Z88.8","F43.10","G43.909","V58.89","Z76.0","G40.201","E87.2","R19.7","R73.9","Z87.820","Z20.822","Z53.29","G47.00","S43.52XA","Z11.3","Z11.4","K02.9","S02.5XXA","Z82.49","Z83.3","S43.102A","S49.92XA","M25.512","F13.239","S06.0X0A","S62.367A","R55.","S20.211A","Z79.891","T42.3X5A","R07.89","G40.822","Z91.138","A08.4","G25.71"],"date":["2021-09-01","2021-09-01","2022-09-30","2022-10-05","2021-09-01","2020-02-06","2020-02-06","2021-03-10","2021-03-10","2021-04-21","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-09-30","2022-09-30","2022-07-02","2022-07-02","2022-07-02","2022-11-28","2022-11-28","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-07-02","2022-07-02","2021-02-16","2021-02-17","2021-02-16","2021-12-13","2022-05-04","2022-05-28","2022-07-02","2022-05-28","2022-05-28","2022-07-02","2022-05-28","2022-05-28","2022-06-27","2022-07-02","2021-12-13","2021-04-09","2021-04-09","2022-10-05","2022-07-02","2022-07-02","2022-07-02","2022-07-02","2022-07-02","2022-07-02","2022-07-02","2021-04-05","2021-04-05","2021-04-05","2021-04-05","2020-02-06","2020-02-06","2020-02-06","2020-02-06","2021-04-13","2021-04-06","2021-04-06","2020-04-24","2020-10-12","2021-03-08","2022-05-04","2022-06-27","2020-04-28","2020-04-28","2022-06-27","2022-07-02","2022-07-02","2022-07-02","2022-03-07"],"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":[["","43547040710","CLONAZEPAM","TAB 1MG","60","Select","Select",""],["","50474050015","NAYZILAM","SPR 5MG","6","Select","Select",""],["","49884015676","VARENICLINE","TAB 1MG","42","Select","Select",""],["","00069046956","CHANTIX","TAB 1MG","42","Select","Select",""],["","00143145801","PHENOBARB","TAB 100MG","90","Select","Select",""],["","65862019399","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","50474059540","KEPPRA","TAB 500MG","120","Select","Select",""],["","00555009796","CLONAZEP","TAB 1MG","15","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","28","Select","Select",""],["","43598016530","OLANZAPINE","TAB 7.5MG","30","Select","Select",""],["","00173064360","LAMICTAL","TAB 150MG","120","Select","Select",""],["","51672413204","LAMOTRIGINE","TAB 150MG","120","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","68382004101","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00536137206","NICOTINE","GUM 4MG MINT","150","Select","Select",""],["","13668009290","PRAMIPEXOLE","TAB 0.25MG","60","Select","Select",""],["","31722053712","LEVETIRACETA","TAB 500MG","120","Select","Select",""],["","70710132501","CLOBAZAM","TAB 10MG","60","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","28","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","28","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","20","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","10","Select","Select",""],["","50228035290","PREGABALIN","CAP 75MG","120","Select","Select",""],["","58160088552","FLUARIX","INJ 2020-21","0","Select","Select",""],["","51991074690","DULOXETINE","CAP 20MG","14","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","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":""}]}]}