{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ATTESORNAYRB ","gend":1,"add":"DNACS 0056LP EKAL AI","city":"SANDSTON","state":"VA","zip":"231509999","dob":"1955-07-19","age":"","mstatus":"","insh":"37202210590","cliId":"","pno":"3840810519","cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","pcpfaxno":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["S43.012A","M54.12","Z78.9","S89.92XA","S93.402A","W19.XXXA","Y92.89","Y93.89","M25.562","Z04.3","W18.2XXA","Y93.E1","F17.200","R00.1","R07.9","I21.4","J98.11","Z68.41","D75.1","E66.01","J45.909","I44.7","L50.0","I25.110","Z88.6","Z98.61","Z88.8","I25.10","I51.7","I36.1","R05","R09.89","I11.9","E78.00","F41.9","R55","M47.812","S09.90XA","S00.03XA","H05.232","S05.12XA","Z72.0","X58.XXXA","I25.2","S00.12XA","Z66","Z95.5","Z79.82","Z79.899","F32.9"],"date":["2019-03-12","2019-04-16","2019-03-13","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-08-12","2019-12-12","2019-10-19","2019-10-17","2019-10-29","2019-10-20","2019-12-12","2019-10-20","2019-12-12","2019-12-12","2019-12-12","2019-10-18","2019-10-19","2019-10-18","2019-10-17","2019-10-19","2019-12-12","2019-10-18","2019-10-18","2019-10-19","2019-10-20","2019-10-29","2020-05-04","2020-05-04","2019-12-12","2019-12-10","2019-12-10","2019-12-12","2019-12-10","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2020-05-04"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""]]]},{"t":"Self-Assessment and Social History","q":[{"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":[["2020-06-25","69315090401","LORAZEPAM","0.5MG","","Select","Select",""],["2019-08-12","10702000709","CYCLOBENZAPR","10MG","","Select","Select",""],["2019-08-12","16729018201","HYDROCHLOROT","12.5MG","","Select","Select",""],["2019-08-12","406012301","HYDROCO\/APAP","5-325MG","","Select","Select",""],["2020-06-25","50111078751","AZITHROMYCIN","250MG","","Select","Select",""],["2020-04-07","68645056854","ATORVASTATIN","40MG","","Select","Select",""],["2020-07-01","60505015801","BUPROPION","75MG","","Select","Select",""],["2020-07-01","49035056314","ASPIRIN LOW","81MG EC","","Select","Select",""],["2020-05-11","65162047810","NITROFURANTN","100MG","","Select","Select",""],["2020-04-30","60505464303","PRASUGREL","10MG","","Select","Select",""],["2019-10-20","591544310","PREDNISONE","20MG","","Select","Select",""],["2019-10-20","43598043611","NITROGLYCERN","0.4MG","","Select","Select",""],["2020-04-10","228202750","ALPRAZOLAM","0.25MG","","Select","Select",""],["2019-03-22","65162025350","RANITIDINE","150MG","","Select","Select",""],["2019-03-13","59746000103","METHYLPRED","4MG","","Select","Select",""],["2019-03-13","93005805","TRAMADOL HCL","50MG","","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":"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":""}]}]}