{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ENIMSAJDRAWOH M ","gend":1,"add":"NOTROM 718322 TPA RD ","city":"RICHMOND","state":"VA","zip":"23223-9998","dob":"2000-02-10","age":"","mstatus":"","insh":"5924110*92","cliId":"","pno":"62\/4084636-3","cno":"","email":"","ename":"","eno":"","pphy":"FP-CARE INC, FOCUS FP","ppno":"617\/304-5967","pcpadd":"500 W CUMMINGS PARK STE 2700","pcpcity":"WOBURN","pcpstate":"MA","pcpzip":1801,"pcpcounty":"","pcpid":"","pcpname":"FOCUS CARE SOLUTIONS INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","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":["J02.9","R30.0","A63.8","J30.9","F90.2","N39.0","N72.","R10.11","R11.2","R19.7","N76.0","R10.9","Z20.828","R10.31","N83.201","N83.209","I49.9","F31.5","H66.91","J03.90","N30.01","B96.89","N89.8","R39.9","F33.1","F43.9","F43.29","F48.9","R11.10","F32.9","F41.9","Z30.46","Z32.02","Z30.017","Z20.822","J06.9","K37.","K38.8","J01.90","R51.","R06.02","R00.0","R50.9","R05.","Z01.419","F90.0","F43.20","M94.0","N83.202","F98.8","F70.","N94.6","Z11.3","N92.6","F17.200","R35.0"],"date":["2021-09-08","2020-02-02","2020-06-23","2021-09-08","2020-11-30","2021-09-21","2020-11-12","2020-12-04","2020-12-04","2020-12-04","2020-07-03","2020-07-03","2021-04-01","2021-07-24","2021-07-24","2020-01-08","2020-07-06","2021-03-03","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2021-09-15","2021-09-15","2020-04-19","2020-10-10","2020-10-10","2020-10-10","2021-04-10","2020-11-17","2020-11-17","2021-08-24","2021-08-24","2021-08-24","2021-09-08","2021-09-08","2020-07-04","2020-07-04","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2021-06-07","2019-09-20","2019-05-07","2019-05-26","2019-12-26","2019-07-24","2019-07-24","2019-06-27","2019-07-18","2019-06-21","2019-06-21","2019-06-21"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","","BUPROPION","TAB 75MG","","Select","Select",""],["","00052433001","NEXPLANON","IMP 68MG","1","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","65862049001","QUETIAPINE","TAB 50MG","60","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","20","Select","Select",""],["","47781030801","NITROFUR","CAP 100MG","14","Select","Select",""],["","","ADDERALL"," ADDERALL ","30","Select","Select",""],["","","AMPHET\/DEXTR"," AMPHET\/DEXTR ","30","Select","Select",""],["","","LORATADINE"," LORATADINE ","30","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","30","Select","Select",""],["","","PENICILLN"," PENICILLN ","30","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","12","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","20","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","4","Select","Select",""],["","","PHENAZOPYRID"," PHENAZOPYRID ","6","Select","Select",""],["","","SMZ\/TMP"," SMZ\/TMP ","10","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","","DICYCLOMINE","TAB 20MG","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","CVS","LOZ THROAT","","Select","Select",""],["","","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","","SUCRALFATE","SUS 1GM\/10ML","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","OXYCODONE","TAB 5MG","","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":""}]}]}