{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA MCCLENDON","gend":1,"add":"3401 GEO WASHINGTON HWY LOT 22","city":"PORTSMOUTH","state":"VA","zip":"23704-9998","dob":"1984-05-24","age":"","mstatus":"","insh":"6879632*01","cliId":"","pno":"757\/405-6273","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":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/539-4824","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R06.02","R06.9","K02.9","J45.909","I50.9","F17.210","Z79.899","K08.89","M20.12","M20.11","M24.572","M24.571","M79.672","M79.671","M25.562","J45.901","M54.5","R52.","M54.89","R07.9","E87.6","NO DATA","R53.83","R53.1","Z20.822","R06.00","L29.9","R21.","R07.89"],"date":["2022-07-09","2020-10-11","2020-11-17","2022-01-29","2020-11-17","2022-01-29","2020-11-17","2020-11-17","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2020-03-27","2019-07-15","2019-01-07","2019-01-07","2019-01-07","2019-01-07","2022-06-23","2022-07-09","2022-07-09","2022-07-09","2022-07-09","2022-07-09","2022-07-09","2022-01-29","2022-01-29","2022-06-23"],"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":[["","00472024260","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","5","Select","Select",""],["","","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","68645055054","LISINOPRIL","TAB 2.5MG","90","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","","CARVEDILOL","TAB 3.125MG","","Select","Select",""],["","","DICLOFENAC","GEL 0.01","","Select","Select",""],["","","SUCRALFATE","SUS 1GM\/10ML","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","57664037708","TRAMADOL","TAB 50MG","12","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":""}]}]}