{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ATTEYRAYELOOD M","gend":1,"add":"LHCIB 5443WN EVA NWA","city":"ROANOKE","state":"VA","zip":"24012-9998","dob":"1950-12-07","age":"","mstatus":"","insh":"00115431","cliId":"","pno":"9404505734","cno":"","email":"","ename":"","eno":"","pphy":"KEILMAN, DAVID A","ppno":5402651607,"pcpadd":"4910 Valley View Blvd Nw Ste 10, ","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240122040,"pcpcounty":"","pcpid":"","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3445 BICHLAWN AVE NW","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24012-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M13.0","Z79.899","G89.4","M47.9","M54.5","M54.2","M47.816","N39.3","H40.1131","H52.13","I48.0","Z86.79","Z98.890","I10","M19.172","M25.372","M25.572","M79.672","R60.0","G60.9","S82.109A","E78.00","M54.32","M54.9","R52","F33.1","N21.0","F11.20","R30.0","M46.1","I71.4","R10.12","R10.13","R11.2","I25.10","I48.91","I48.92","Z79.01","Z79.82","K59.03","R74.8","S22.080A","M25.511","M75.01","K59.04","R10.9","K21.9","D50.9","E66.9","E78.2","F41.1","G47.00","G62.9","H04.129","H54.3","H55.89","H81.10","I49.9","K08.109","L85.3","L90.5","M25.9","Z68.39","Z79.891","Z82.49","Z91.81","S22.080G","M80.00XG","I71.2","R42","R53.83","Z87.81","M51.26","L03.115","R19.7","D12.3","D12.4","K62.1","K29.50","K63.89","K57.30","K64.8","K22.8","K29.70","Q39.9","J45.909","K59.00","R10.84","R11.0","N20.0","Z90.49","F41.9","M25.561","T82.330A","M47.814","I77.1","H25.13","H01.02A","Z23","J01.40","M54.89"],"date":["2022-01-26","2022-01-26","2022-01-26","2022-01-26","2021-04-07","2019-10-28","2021-07-30","2022-02-15","2022-02-17","2021-01-07","2021-04-05","2021-04-05","2021-04-05","2021-06-03","2018-01-15","2018-01-15","2020-07-20","2018-01-15","2018-01-15","2018-01-15","2021-10-21","2021-02-03","2019-04-11","2020-07-20","2018-06-25","2018-02-23","2018-02-23","2018-02-23","2020-03-02","2019-04-04","2021-04-05","2019-04-09","2019-04-09","2019-08-09","2019-08-09","2019-08-09","2019-04-09","2019-08-09","2019-08-09","2019-04-11","2021-10-12","2021-04-21","2021-04-21","2021-04-21","2020-07-20","2020-08-20","2019-08-09","2018-05-25","2018-05-25","2018-05-25","2019-07-30","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2018-05-25","2020-07-20","2021-06-09","2021-06-09","2018-07-06","2018-06-18","2018-06-18","2020-07-20","2021-07-30","2018-10-12","2020-08-21","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2020-08-20","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2019-08-09","2020-08-21","2020-08-21","2020-08-20","2020-08-20","2018-08-24","2018-08-24","2020-08-27","2020-08-27","2020-08-27","2018-09-07","2021-10-14","2018-10-12","2021-10-12","2018-11-10"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"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":[["","16714008402","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","16714084401","AMIODARONE","TAB 200MG","30","Select","Select",""],["","16714087502","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00406012505","HYDROCO\/APAP","TAB 10-325MG","180","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","57841130001","MOVANTIK","TAB 12.5MG","30","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","2.5","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","59385004130","SYMPROIC","TAB 0.2MG","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","14539067401","HYDROXYZ","CAP 25MG","90","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","120","Select","Select",""],["","59385002360","BELBUCA","MIS 300MCG","60","Select","Select",""],["","58914017014","CARAFATE","SUS 1GM\/10ML","1,200.00","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","10","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","20","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","20","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","21","Select","Select",""],["","65162010350","GABAPENTIN","CAP 400MG","90","Select","Select",""],["","53489011802","DOXYCYCL","CAP 50MG","30","Select","Select",""],["","65597030110","MORPHABOND","TAB 15MG ER","60","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","59651006605","OLOPATADINE","SOL 0.002","2.5","Select","Select",""],["","42858049340","BUPRENORPHIN","DIS 10MCG\/HR","4","Select","Select",""],["","00574402435","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","120","Select","Select",""],["","24208079535","NEO\/POLY\/DEX","OIN 0.1% OP","3.5","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","64980034003","ALENDRONATE","TAB 10MG","90","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":""}]}]}