{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DENIKA COLEMAN","gend":1,"add":"811   MCDOWELL AVENUE NW                                    ","city":"ROANOKE                       ","state":"VA","zip":"24016-1113","dob":"1984-11-07","age":"","mstatus":"","insh":6842546,"cliId":"","pno":5409049361,"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":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"811   MCDOWELL AVENUE NW                                    ","add3":"","madd1":"811   MCDOWELL AVENUE NW                                    ","madd2":"                                                            ","madd3":"","mcity":"ROANOKE                       ","mstate":"VA","mzip":"24016-1113","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.32","N83.9","Z30.431","N83.291","M25.532","S63.502A","S69.92XA","X50.9XXA","J45.909","Z87.891","X50.0XXA","F31.9","F51.5","F39","F41.9","F32.9","F31.5","F43.10","S39.012A","G89.29","M54.5","F17.200","M54.16","M53.3","M47.27","M51.26","M54.42","N83.8","Z97.5","M54.9","Y93.F2","Y99.0","N39.0","R11.0","R10.31","G43.909","R10.2","N83.201","B34.9","R05","R52","E66.9","M19.90","Z68.41","J11.1","R11.2","F31.81","F25.0","F31.32","I86.2","K52.9","J30.2","R20.0","R20.2","A59.9","Z11.3","Z30.432","Z01.419","R10.9","M51.17","M99.73","K80.20","R53.1","M51.27","M25.552","W10.9XXA","D72.829","W19.XXXA","M16.12","M54.17","Z20.822","G47.00","R10.84","M79.662","S86.812A","M25.48","S86.002A","M79.605","Y93.01","S89.92XA","S86.012D","X58.XXXA","S86.012A","F43.9","F14.10","F22","Z04.6","Z79.899","Z20.2","F14.20","S81.831A","S81.801A","W54.0XXA","Y93.89","Y92.9","S71.102A","Z23","Z20.3","Z29.14","S81.851A","S71.152A","S99.919A","S80.11XD","W54.0XXD","Y93.9","S70.12XD","Z32.02","S00.03XA","S00.83XA","R51.9","Y04.0XXA","Y92.89","S50.811A","S50.311A","S40.811A","Z53.29","M25.521","S09.90XA","T14.90XA","M25.551","Y09","M54.6","R07.89","S06.0X0A","M54.2","S09.93XA","S19.9XXA","R87.610","H11.31","S01.111A","S05.91XA","S05.90XA"],"date":["2020-12-24","2020-10-21","2020-01-07","2020-04-14","2020-01-21","2020-01-21","2020-01-21","2020-02-21","2022-10-17","2020-06-04","2020-05-16","2022-05-05","2021-04-07","2021-04-07","2021-04-07","2021-03-10","2020-04-02","2020-06-18","2020-05-19","2021-03-29","2021-01-17","2020-11-28","2021-01-04","2020-03-11","2020-03-11","2020-12-23","2020-12-12","2020-10-21","2020-10-21","2021-03-29","2020-05-16","2020-05-16","2020-05-26","2020-11-28","2020-05-26","2020-12-12","2020-12-04","2020-05-29","2020-06-04","2020-06-04","2022-06-27","2021-03-29","2021-05-01","2021-03-29","2020-06-04","2021-03-29","2020-06-18","2022-11-17","2021-01-14","2020-10-21","2020-11-06","2020-11-06","2020-12-12","2020-11-13","2020-11-16","2022-08-24","2020-11-16","2022-08-24","2021-03-29","2021-01-04","2020-12-08","2020-12-08","2020-12-12","2020-12-23","2022-06-27","2021-05-05","2020-12-24","2022-05-29","2020-12-24","2021-01-04","2021-01-17","2021-02-09","2022-03-26","2021-05-05","2021-05-13","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2021-05-13","2022-06-27","2021-05-15","2022-05-05","2022-01-28","2022-01-28","2022-01-28","2022-10-17","2022-03-26","2022-05-12","2022-04-20","2022-04-20","2022-04-20","2022-06-27","2022-10-17","2022-04-20","2022-04-20","2022-04-23","2022-04-23","2022-04-20","2022-04-20","2022-04-20","2022-04-23","2022-04-23","2022-10-17","2022-04-23","2022-08-24","2022-05-29","2022-05-29","2022-06-27","2022-10-17","2022-06-27","2022-05-29","2022-05-29","2022-05-29","2022-05-29","2022-05-29","2022-06-27","2022-05-29","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-08-24","2022-10-17","2022-10-17","2022-10-17","2022-10-17"],"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":[]},{"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":[["","10702001801","OXYCODONE","TAB 5MG","8","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","42571013725","KETOROLAC","SOL 0.005","5","Select","Select",""],["","24208078555","NEO\/POLY\/BAC","OIN \/HC 1%OP","3.5","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","30","Select","Select",""],["","","HYDROXYZ","TAB 10MG","360","Select","Select",""],["","","ARIPIPRAZOLE","TAB 5MG","90","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","30","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","21","Select","Select",""],["","65862052790","VENLAFAXINE","CAP 37.5 ER","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","8","Select","Select",""],["","","QUETIAPINE","TAB 50MG","180","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","10","Select","Select",""],["","00904672080","ACETAMIN","TAB 500MG","56","Select","Select",""],["","00536406301","CL","TAB 28-0.8MG","90","Select","Select",""],["","","BUPROPION","TAB 100MG","90","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","30","Select","Select",""],["","00603533831","PREDNISONE","PAK 10MG","48","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","90","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","90","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","","BUSPIRONE","TAB 15MG","180","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","21","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","67877057505","BENZONATATE","CAP 200MG","10","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","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":""}]}]}