{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ERIKA   V RODRIGUEZ","gend":1,"add":"881 CATALINA DR APT 2","city":"NEWPORT NEWS","state":"VA","zip":"23608-9998","dob":"1988-05-07","age":"","mstatus":"","insh":"1931365*01","cliId":"","pno":"732\/979-7842","cno":"","email":"","ename":"","eno":"","pphy":"SOTO GUERRERO, YAZMIN MD","ppno":"757\/877-1529","pcpadd":"SUITE 7B 710 DENBIGH BLVD","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23608,"pcpcounty":"","pcpid":"","pcpname":"RIVERA-SOTO MEDICAL GROUP INTERNAL MEDICINE SPECIALISTS LLC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/877-2874","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.9","J30.1","J30.89","J18.9","H10.13","L85.8","D23.9","L85.3","Z71.9","Z28.21","J06.9","J45.909","R51.","J32.9","D64.9","G43.909","H92.01","J02.0","M50.20","L20.9","H66.91","J30.9","N76.0","B37.9","B37.2","B96.89","Z11.3","R51.9","J01.90","Z32.01","R10.2","M54.12","G95.9","R05.","E78.00","R19.7","Z01.419","J20.9","R07.0","O98.519","U07.1","O99.891","R05.9","Z3A.00","Z79.899","R09.81","K29.70","Z11.59","Z30.09","J40.","M25.561","M25.562","Z20.822","F32.9"],"date":["2021-04-12","2020-04-27","2020-04-27","2019-10-31","2020-04-27","2019-10-30","2019-10-30","2019-10-30","2019-10-30","2019-10-30","2021-12-31","2020-09-04","2020-02-03","2021-04-12","2021-05-19","2021-04-12","2020-04-27","2021-07-26","2019-11-15","2019-05-29","2020-05-11","2020-02-18","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-01-07","2021-03-30","2021-03-30","2021-12-29","2021-12-29","2019-11-15","2019-03-14","2020-01-27","2019-12-10","2019-12-10","2020-08-19","2020-08-28","2020-08-28","2021-12-31","2021-12-31","2021-12-31","2021-12-31","2021-12-31","2021-12-31","2021-12-31","2019-11-15","2020-09-16","2019-07-26","2020-09-04","2020-09-18","2020-09-18","2021-12-31","2019-04-09"],"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":[["","","SUMATRIPTAN"," SUMATRIPTAN ","9","Select","Select",""],["","","RA"," RA ","60","Select","Select",""],["","","PREPLUS"," PREPLUS ","30","Select","Select",""],["","","CLOBETASOL"," CLOBETASOL ","30","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","30","Select","Select",""],["","","LORATADINE"," LORATADINE ","30","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","30","Select","Select",""],["","","OMEPRAZOLE"," OMEPRAZOLE ","30","Select","Select",""],["","","ANTIFUNGAL"," ANTIFUNGAL ","30","Select","Select",""],["","","TUSSIN"," TUSSIN ","118","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","17","Select","Select",""],["","","GUAIFENESIN"," GUAIFENESIN ","100","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","3","Select","Select",""],["","","DEXAMETHASON"," DEXAMETHASON ","150","Select","Select",""],["","","CVS","TAB 600MG","","Select","Select",""],["","","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","","AMOX\/K","TAB 500-125","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","","PRENATAL+DHA","MIS WOMENS","","Select","Select",""],["","","MONTELUKAST","TAB 10MG","","Select","Select",""],["","","MELOXICAM","TAB 15MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","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":""}]}]}