{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AMANDA   E MOWLES","gend":1,"add":"1866 ELBERT DRIVE","city":"ROANOKE","state":"VA","zip":"24018-2752","dob":"1991-02-26","age":"","mstatus":"","insh":4640301,"cliId":"","pno":5405299453,"cno":5405951159,"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":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"1866 ELBERT DRIVE","madd2":"","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24018-2752","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R68.89","F11.20","L03.113","R42","R51","R41.0","F17.200","Z86.72","R41.82","L03.114","I80.9","F19.10","A41.9","M79.89","M79.602","M79.601","J45.909","F31.9","F17.210","Z20.828","Z11.59","R00.0","F32.9","L02.414","L02.415","R21","F11.90","W46.0XXA","Y92.9","B18.2","F11.10","L98.499","L02.413","Z91.19","Z56.0","Z86.14","R06.02","S51.802A","S51.801A","X58.XXXA","Y93.9","Z79.899"],"date":["2020-04-06","2020-12-10","2020-12-20","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-12-20","2020-05-12","2022-03-16","2020-11-29","2020-12-19","2020-11-29","2020-11-29","2022-03-16","2020-11-29","2020-12-19","2020-11-29","2020-11-29","2020-12-09","2020-12-19","2020-12-19","2020-12-19","2020-12-19","2020-12-19","2020-12-19","2022-03-16","2020-12-19","2020-12-19","2020-12-19","2022-03-16","2020-12-19","2020-12-19","2020-12-19","2021-10-11","2022-03-16","2022-03-16","2022-03-16","2022-03-16","2022-03-16"],"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":[["","00093314705","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","20","Select","Select",""],["","51224012230","AZITHROMYCIN","TAB 500MG","2","Select","Select",""],["","49100040007","CULTURELLE","CAP ","40","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","60","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":""}]}]}