{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID   B FRANCISCO","gend":0,"add":"1117 MOUNT VERNON LN","city":"SALEM","state":"VA","zip":"24153-9998","dob":"1964-12-26","age":"","mstatus":"","insh":"900046264*01","cliId":"","pno":"540\/404-9036","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":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","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":["D53.9","Z79.899","G47.39","E66.9","Z68.35","E11.9","K21.9","J44.9","F20.9","F02.81","E03.9","F32.9","G30.9","E11.51","I87.2","H43.391","M79.671","M25.571","G47.33","Z00.00","Z12.11","Z23.","Z94.7"],"date":["2021-02-23","2021-02-23","2021-03-04","2021-03-04","2021-03-04","2021-03-15","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-12-23","2021-12-23","2021-09-27","2021-07-30","2021-07-30","2021-09-09","2021-06-04","2021-06-04","2021-10-03","2021-06-08"],"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":[]}]},{"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":[["","68180044501","QUETIAPINE FUMARATE                                                   ","25MG","30","Select","Select",""],["","00093585101","ESCITALOPRAM OXALATE                                                  ","10MG","45","Select","Select",""],["","43547027609","DONEPEZIL HCL                                                         ","10MG","30","Select","Select",""],["","00904679480","ASPIRIN LOW DOSE                                                      ","81MG","30","Select","Select",""],["","00781518292","LEVOTHYROXINE SODIUM                                                  ","75MCG","30","Select","Select",""],["","45802057178","FEXOFENADINE HYDROCHLORIDE                                            ","180MG","30","Select","Select",""],["","00781207601","TAMSULOSIN HYDROCHLORIDE                                              ","0.4MG","30","Select","Select",""],["","61314022710","TIMOLOL MALEATE                                                       ","0.5% OP","10","Select","Select",""],["","00054252625","LITHIUM CARBONATE                                                     ","150MG","60","Select","Select",""],["","96295013532","                                                                      ","","60","Select","Select",""],["","45802005911","NYSTATIN                                                              ","100000","30","Select","Select",""],["","61442012110","FAMOTIDINE                                                            ","20MG","60","Select","Select",""],["","61314054701","LATANOPROST                                                           ","0.01%","2","Select","Select",""],["","37000074091","METAMUCIL                                                             ","","24","Select","Select",""],["","60758088005","FLUOROMETHOLONE                                                       ","0.1% OP","5","Select","Select",""],["","11845006935","VITAMIN B-12                                                          ","1000MCG","30","Select","Select",""],["","00469260130","MYRBETRIQ                                                             ","25MG","30","Select","Select",""],["","00054004544","IPRATROPIUM BROMIDE                                                   ","0.03%","30","Select","Select",""],["","00536430611","FIBER-LAX                                                             ","625MG","34","Select","Select",""],["","00093031101","LOPERAMIDE HCL                                                        ","2MG","60","Select","Select",""],["","00536108494","ARTIFICIAL TEARS                                                      ","1.4% OP","15","Select","Select",""],["","80681009501","REGULOID                                                              ","48.57%","538","Select","Select",""],["","49281072110","FLUBLOK QUADRIVALENT 2021-2022                                        ","2021-22","0","Select","Select",""],["","70000032101","ATHLETES FOOT POWDER SPRAY                                            ","2%","130","Select","Select",""],["","11017041025","LOTRIMIN AF POWDER                                                    ","2%","133","Select","Select",""],["","86790016280","BENEFIBER ON THE GO                                                   ","THE GO","28","Select","Select",""],["","00781261305","AMOXICILLIN                                                           ","500MG","28","Select","Select",""],["","59762371901","ALPRAZOLAM                                                            ","0.25MG","2","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}