{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   DERDLIMNIFFIRG D","gend":1,"add":"IRAM 868EVA ATTE","city":"NORFOLK","state":"VA","zip":"23513-9998","dob":"1956-04-18","age":"","mstatus":"","insh":"74000910*622","cliId":"","pno":"1375776589","cno":"","email":"","ename":"","eno":"","pphy":"FP-CARE INC, FOCUS FP","ppno":6173045967,"pcpadd":"500 W CUMMINGS PARK STE 2700","pcpcity":"WOBURN","pcpstate":"MA","pcpzip":"01801-9998","pcpcounty":"","pcpid":"","pcpname":"FOCUS CARE SOLUTIONS INC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","Z23.","G47.33","E66.01","M15.9","Z12.11","D12.3","K62.0","C18.5","L02.212","I35.0","M19.91","E87.6","C18.9","K43.9","K42.9","K57.30","Z87.19","Z12.31","M25.569","N63.12","R92.8","K62.5","K92.1","M17.12","K63.5","Z13.79","Z01.810","Z01.812","I49.1","R68.89","C18.4","D12.8","Z68.42","Z87.891","Z79.899","N95.0","E78.5","Z87.39","Z74.09","Z99.89","Z68.41"],"date":["2022-04-21","2021-10-07","2022-03-09","2022-04-21","2021-10-07","2022-03-11","2022-03-08","2022-03-08","2022-07-26","2021-07-07","2022-03-09","2022-03-09","2022-03-09","2022-04-21","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-08-15","2022-03-09","2022-08-22","2022-08-22","2021-08-10","2021-08-10","2021-08-10","2022-03-08","2022-03-18","2022-04-01","2022-04-01","2022-04-01","2022-05-05","2022-04-11","2022-03-08","2022-04-11","2022-03-08","2022-04-21","2021-04-12","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-21"],"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":[["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","68682010610","NIFEDIPINE","TAB 60MG ER","90","Select","Select",""],["","70954039110","ATENOL\/CHLOR","TAB 100-25MG","90","Select","Select",""],["","68180063709","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","69238106901","POT CHLORIDE","TAB 20MEQ ER","60","Select","Select",""],["","55566670001","CLENPIQ","SOL ","320","Select","Select",""],["","16571066401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","00093117701","NEOMYCIN","TAB 500MG","4","Select","Select",""],["","70461012203","FLUAD QUADRI","INJ 2022-23","0","Select","Select",""],["","68180063709","ATORVASTATIN TAB","40MG","90","Select","Select",""],["","69238106901","POT CHLORIDE TAB","20MEQ ER","60","Select","Select",""],["","68682010610","NIFEDIPINE TAB","60MG ER","90","Select","Select",""],["","59267100002","PFIZER VACC INJ COVID-","19","0","Select","Select",""],["","70954039110","ATENOL\/CHLOR TAB","100-25MG","90","Select","Select",""],["","70461012203","FLUAD QUADRI INJ","2022-23","0","Select","Select",""],["","55566670001","CLENPIQ SOL","","320","Select","Select",""],["","16571066401","METRONIDAZOL TAB","500MG","4","Select","Select",""],["","00093117701","NEOMYCIN TAB","500MG","4","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":""}]}]}