{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LISA   C GETTIER","gend":1,"add":"2231 MARTLET LN","city":"VIRGINIA BEACH","state":"VA","zip":"23456-9998","dob":"1971-11-13","age":"","mstatus":"","insh":"1036454*02","cliId":"","pno":"757\/620-5923","cno":"757\/620-5923","email":"","ename":"","eno":"","pphy":"BICE, HAMILTON L DO","ppno":"757\/395-6630","pcpadd":"STE 200 1080 FIRST COLONIAL RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23454,"pcpcounty":"","pcpid":117381,"pcpname":"Cape Charles Medical Center","plan":"OHP","program":"ACA","lob":"Small Group","region":"TIDEWATER","aligned":"","ano":"757\/620-5926","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":["R00.1","I50.22","R94.5","R63.0","E03.9","E87.6","S72.145A","F50.00","I42.8","E46.","Z68.1","M70.62","M81.0","F41.0","T50.2X5A","Z20.828","Z79.899","Z79.83","Z79.890","Z88.0","M54.89","S72.002D","R79.89","I10.","Z98.890","E43.","Z87.81","R03.0","I50.9","E87.2","I15.1","Z00.00","I42.5","M25.552","W19.XXXA","Z01.818","Z12.4","I42.0","M85.852","Z78.0","E44.0","Z23.","M81.8","R23.3","S20.212A","S70.02XA","M79.89","M25.452","S73.192A","M25.852","S72.002A","S72.142A","S72.142D","I11.0","F41.1","F32.9","Z79.82","Z87.891","Z91.81","I20.8","R06.02","I49.3","I49.1","M84.374A","Z12.39","I49.9","Z47.89","D72.819","D72.810","D64.9","M25.571","L57.8","D22.5","L82.1","L57.0","R63.6","Z13.820","Z48.89","R07.89","R74.01","R07.9","S76.012A","I50.33","E87.0","R64.","E87.3","E27.40","R94.31","R14.0","K82.8","N20.0","N28.1","R11.0","R10.84","K76.9","M84.374D","N91.2","Z01.419","R92.2","L81.2","D69.0","D69.2","R10.13","Z12.31","J90.","I34.0","I51.7","I51.89","Z86.59","I47.2","I50.42"],"date":["2021-07-22","2021-06-04","2020-03-27","2021-04-16","2021-07-13","2021-06-03","2020-11-30","2020-11-30","2021-06-04","2020-11-30","2021-03-28","2020-12-08","2020-12-04","2020-11-30","2020-11-30","2020-11-30","2021-04-05","2020-11-30","2021-04-05","2021-04-05","2020-12-08","2021-04-16","2021-04-16","2021-07-13","2021-02-03","2021-07-13","2021-02-03","2021-03-18","2021-03-31","2021-03-31","2021-07-13","2020-11-30","2021-04-16","2020-11-30","2020-11-25","2020-11-30","2021-05-24","2021-06-04","2020-02-19","2020-02-19","2021-03-28","2020-09-21","2021-07-13","2020-09-21","2020-11-21","2020-11-21","2021-01-14","2020-11-29","2020-11-29","2020-11-29","2020-12-01","2020-12-01","2020-12-04","2021-03-28","2020-12-04","2020-12-04","2020-12-04","2021-04-05","2020-12-04","2021-04-05","2021-04-05","2021-04-30","2021-04-30","2020-01-06","2020-08-07","2020-12-01","2020-12-01","2021-01-23","2021-01-23","2021-01-23","2021-01-23","2021-04-21","2021-04-21","2021-04-21","2021-04-21","2021-04-27","2020-02-19","2021-03-18","2021-03-28","2021-03-28","2021-03-31","2020-11-29","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2021-03-28","2020-05-19","2020-07-22","2020-07-22","2020-07-22","2020-08-17","2020-08-17","2020-08-17","2021-03-28","2020-06-16","2020-12-01","2021-03-30","2021-03-30","2021-04-05","2021-04-05","2021-07-22","2021-07-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","64380080707","IBUPROFEN","800MG","30","Select","Select",""],["","62559072101","TERBUTALINE","2.5MG","60","Select","Select",""],["","68180051301","LISINOPRIL","5MG","30","Select","Select",""],["","69238183401","LEVOTHYROXIN","100MCG","90","Select","Select",""],["","69315011610","FUROSEMIDE","20MG","-60","Select","Select",""],["","69097022416","ALENDRONATE","70MG","12","Select","Select",""],["","00126007492","PREVDNT","1.10%","100","Select","Select",""],["","68462035701","POT CHLORIDE","10MEQ ER","180","Select","Select",""],["","00904674460","ASPIRIN","325MG","60","Select","Select",""],["","00574060801","FERROUS","324MG EC","30","Select","Select",""],["","68462030201","INDOMETHACIN","50MG","20","Select","Select",""],["","10702001850","OXYCODONE","5MG","42","Select","Select",""],["","00574029201","AMILORIDE","5MG","180","Select","Select",""],["","00832532510","POT CL MICRO","20MEQ ER","-60","Select","Select",""],["","68180071909","AMLODIPINE","2.5MG","30","Select","Select",""],["","00245531911","KLOR-CON","20MEQ ER","60","Select","Select",""],["","13107005999","APAP\/CODEINE","300-30MG","15","Select","Select",""],["","65162062750","TRAMADOL","50MG","20","Select","Select",""],["","65862085901","FAMOTIDINE","20MG","60","Select","Select",""],["","51645085101","SENNA","8.6MG","30","Select","Select",""],["","59676058015","JANSSEN","COVID-19","0","Select","Select",""],["","68180051301","LISINOPRIL ","5MG","30","Select","Select",""],["","64380080707","IBUPROFEN ","800MG","30","Select","Select",""],["","62559072101","TERBUTALINE ","2.5MG","60","Select","Select",""],["","69315011610","FUROSEMIDE ","20MG","60","Select","Select",""],["","69238183401","LEVOTHYROXIN ","100MCG","30","Select","Select",""],["","00126007492","PREVDNT ","1.10%","100","Select","Select",""],["","69097022416","ALENDRONATE ","70MG","12","Select","Select",""],["","68382032001","POT  CHLORIDE","10MEQ ER","7","Select","Select",""],["","00904674460","ASPIRIN ","325MG","60","Select","Select",""],["","10702001850","OXYCODONE ","5MG","42","Select","Select",""],["","51645085101","SENNA ","8.6MG","30","Select","Select",""],["","65162062750","TRAMADOL ","50MG","20","Select","Select",""],["","68462030205","INDOMETHACIN ","50MG","-20","Select","Select",""],["","00574060801","FERROUS ","324MG EC","30","Select","Select",""],["","00574029201","AMILORIDE ","5MG","-30","Select","Select",""],["","00832532510","POT  CL MICRO","20MEQ ER","60","Select","Select",""],["","59676058015","JANSSEN ","COVID-19","0","Select","Select",""],["","68180071909","AMLODIPINE ","2.5MG","30","Select","Select",""],["","00245531911","KLOR-CON ","20MEQ ER","60","Select","Select",""],["","69315090405","LORAZEPAM ","0.5MG","1","Select","Select",""],["","60258017101","MAG ","400MG","180","Select","Select",""],["","13107005999","APAP\/CODEINE ","300-30MG","15","Select","Select",""],["","65862085901","FAMOTIDINE ","20MG","60","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}