{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RODOLFO HERNANDEZ","gend":0,"add":"7337 WHIRLAWAY DR","city":"MIDLOTHIAN","state":"VA","zip":231129999,"age":"","mstatus":"","insh":22026894202,"cliId":"","pno":8043055284,"cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","dob":"1959-05-04"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["E11.41","I25.10","G47.33","E78.00","Z95.1","E78.1","M79.641","Z11.59","Z23","I10","E11.9","M54.32","L28.2","M25.512","L81.9","G89.29","Z68.28","          "],"date":["2019-09-18","2020-03-11","2020-03-11","2019-05-29","2020-03-11","2020-03-11","2019-05-29","2019-09-18","2020-02-07","2020-03-11","2020-03-11","2019-10-09","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2020-03-11","2020-03-11"]}},{"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":[["2020-11-06","68180098003","LISINOPRIL","TAB 10MG   ","30","Select","Select",""],["2020-11-06","70377000911","ROSUVASTATIN","TAB 40MG   ","30","Select","Select",""],["2019-08-20","33332031901","AFLURIA QUAD","2019-20","","Select","Select",""],["2019-08-04","58160082311","SHINGRIX","50MCG","","Select","Select",""],["2020-11-09","68382075810","METFORMIN","TAB 500MG   ","60","Select","Select",""],["2020-02-07","51672404801","CLOTRIM\/BETA","DIPROP","","Select","Select",""],["2019-08-20","33332031901","AFLURIA","QUAD INJ 2019-20  ","0.5","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":""}]}]}