{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JONI D MINGUS","gend":1,"add":"202 FOREST ST","city":"HAMPTON","state":"VA","zip":"23669-9998","dob":"1990-03-17","age":"","mstatus":"","insh":"1944115*01","cliId":"","pno":7406063391,"cno":7406063391,"email":"","ename":"","eno":"","pphy":"GEORGE, DYLAN M NP","ppno":7577265000,"pcpadd":"200 EATON ST,","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":"23669-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Old Hampton","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575109223,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H90.3","R29.818","G04.90","R47.9","R56.9","R89.2","G43.909","F41.9","O90.3","I45.6","E46.","E83.42","R64.","Z00.00","Q02.","Z68.1","E43.","E08.65","G40.209","Z86.73","G43.009","Z11.3","G47.00","Z23.","I69.320","G60.9","E11.9","E55.9","F41.8","R63.6","Z79.82","Z79.84","Z87.891","E88.41","R90.89","G40.909","Z79.899","I10.","I63.9","I67.82","R42.","G40.A01","R47.01","E11.65","R25.1","F32.9","Z82.49","Z86.69","Z12.4","E11.29","R80.9","G43.809","H53.9","H47.291","H53.462","G40.109","E88.40","R47.1","R47.02","R29.701","Z09.","G40.119","M25.511","R20.0","R20.2","R41.82","R29.898","H53.012","R29.90","R50.9","H53.19","E10.9","H04.123","NO DATA","V58.69","Z91.14","R73.9","R00.0","R03.0","G40.901","I51.7","R06.00","R93.0","G40.211","G31.9","E87.2","G93.49","Z83.3","H53.453","H47.293","H52.11","H91.90"],"date":["2022-03-04","2021-04-26","2021-03-15","2021-03-15","2023-04-18","2021-03-15","2021-03-24","2023-01-12","2021-03-15","2023-04-18","2021-06-02","2021-03-15","2021-03-15","2021-04-28","2021-11-08","2021-11-08","2021-12-07","2021-11-08","2021-08-30","2022-10-10","2021-08-30","2021-04-28","2021-08-30","2021-04-28","2021-06-02","2021-06-02","2022-01-14","2021-08-30","2021-06-02","2023-07-11","2021-11-08","2021-11-08","2022-10-10","2023-07-11","2021-11-12","2023-07-11","2022-02-27","2022-10-10","2021-03-15","2021-03-15","2021-03-15","2021-03-24","2021-11-08","2021-11-08","2021-03-24","2021-03-24","2021-11-08","2021-07-01","2021-08-30","2021-12-07","2021-12-07","2023-07-11","2021-11-06","2022-03-07","2022-03-07","2021-08-02","2021-03-26","2021-03-10","2021-03-10","2021-03-10","2021-12-07","2021-04-26","2022-10-10","2022-10-10","2022-10-10","2021-03-11","2021-04-03","2021-09-21","2023-01-12","2021-11-08","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2022-10-10","2022-10-10","2021-03-10","2021-03-10","2022-02-27","2021-11-08","2021-03-11","2022-09-09","2021-03-10","2021-03-26","2021-09-04","2021-11-08","2021-11-08","2021-11-08","2022-01-14","2022-01-14","2022-01-14","2023-04-18"],"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":[["","42385095612","LEVETIRACETA","TAB 750MG","120","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","60","Select","Select",""],["","00093342501","LORAZEPAM","TAB 0.5MG","10","Select","Select",""],["","00093310953","AMOXICILLIN","CAP 500MG","10","Select","Select",""],["","68180063709","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","90","Select","Select",""],["","70710116201","MECLIZINE","TAB 25MG","30","Select","Select",""],["","13668033930","LAMOTRIGINE","TAB 25MG ER","30","Select","Select",""],["","57896090101","ASPIRIN","325 MG","34","Select","Select",""],["","00131247935","VIMPAT","TAB 150MG","60","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","55111029198","SUMATRIPTAN","TAB 25MG","9","Select","Select",""],["","50474050015","NAYZILAM","SPR 5MG","2","Select","Select",""],["","51672411101","PHENYTOIN EX","CAP 100MG","60","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","43547035210","LISINOPRIL","5 MG","90","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","72252051002","VALTOCO","SPR 10MG","2","Select","Select",""],["","40985027086","L-ARGININE","1000 MG","45","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","16714055001","LACOSAMIDE","150 MG","180","Select","Select",""],["","65862019301","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","11822317510","RA ASPIRIN","TAB 325MG","30","Select","Select",""],["","53885099425","ONETOUCH ULTRA TEST STRIP","","25","Select","Select",""],["","67877056105","METFORMIN HCL","500 MG","180","Select","Select",""],["","42385095612","LEVETIRACETAM","750 MG","120","Select","Select",""],["","62332002231","FLUOXETINE HCL","10 MG","30","Select","Select",""],["","38779248005","TAURINE","100 %","270","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","100","Select","Select",""],["","59267100002","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","57896090101","ASPIRIN TAB","325MG","30","Select","Select",""],["","43547035210","LISINOPRIL TAB","5MG","90","Select","Select",""],["","55111029198","SUMATRIPTAN TAB","25MG","9","Select","Select",""],["","00131247935","VIMPAT TAB","150MG","60","Select","Select",""],["","42385095612","LEVETIRACETA TAB","750MG","120","Select","Select",""],["","53885024510","ONETOUCH TES ULTRA","","100","Select","Select",""],["","57237000830","MIRTAZAPINE TAB","15MG","90","Select","Select",""],["","67877056105","METFORMIN TAB","500MG","180","Select","Select",""],["","68462068060","LACOSAMIDE TAB","150MG","60","Select","Select",""],["","00093342501","LORAZEPAM TAB","0.5MG","10","Select","Select",""],["","11822317510","RA ASPIRIN TAB","325MG","30","Select","Select",""],["","11822363280","L-ARGININE TAB","1000MG","270","Select","Select",""],["","65862019301","FLUOXETINE CAP","20MG","30","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":""}]}]}