{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHELSEA MONTGOMERY","gend":1,"add":"9601 GARDENIA DR","city":"HENRICO","state":"VA","zip":232289999,"age":"","mstatus":"","insh":22027150402,"cliId":"","pno":7576859366,"cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","dob":"1988-09-14"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R10.13","J06.9","Z32.01","Z34.01","Z36.9","Z11.3","Z11.4","Z13.228","Z13.0","Z13.79","Z01.83","O20.0","O03.9","Z34.81","Z3A.01","R30.0","Z13.89","Z11.51","Z11.8","Z36.82","H66.92","J02.9","J01.10","Z34.02","Z3A.16","Z36.1","Z34.82","O02.1","O45.8X2","Z37.1","Z3A.20","J45.909","Z53.9","O60.12X0","O36.4XX0","O73.1","O20.9","R93.89","N93.9","Z74.3","O72.1","D72.829","O03.4","O03.1","F41.8","L82.1","D22.72","Z87.2","          "],"date":["2019-01-30","2019-03-21","2019-06-24","2019-07-12","2019-06-24","2019-07-12","2019-06-24","2019-06-24","2019-06-24","2019-04-18","2019-06-24","2019-04-24","2019-11-02","2019-06-24","2019-07-12","2019-07-12","2019-07-12","2019-07-12","2019-07-12","2019-08-19","2019-08-29","2019-08-29","2019-08-29","2019-09-16","2019-09-16","2019-09-16","2019-09-16","2019-10-15","2019-10-15","2019-10-15","2019-10-15","2019-11-08","2019-10-14","2019-10-15","2019-10-15","2019-11-08","2019-11-02","2019-11-02","2019-11-02","2019-11-02","2019-11-02","2019-11-02","2019-11-08","2019-11-08","2020-02-17","2020-03-09","2020-03-09","2020-03-09","2020-03-09"]}},{"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":[["2019-11-03","67877032105","IBUPROFEN","800MG","","Select","Select",""],["2019-01-31","64380080307","RANITIDINE","150MG","","Select","Select",""],["2019-01-31","55111015810","OMEPRAZOLE","20MG","","Select","Select",""],["2020-03-17","69097083412","SERTRALINE","50MG","","Select","Select",""],["2019-08-29","66685100100","AMOX\/K CLAV","875-125","","Select","Select",""],["2019-11-03","59762500801","MISOPROSTOL","200MCG","","Select","Select",""],["2019-11-03","603233832","APAP\/CODEINE","300-30MG","","Select","Select",""],["2019-11-03","68462010530","ONDANSETRON","4MG","","Select","Select",""],["2019-08-29","66685100100","AMOX\/K","CLAV TAB 875-125  ","20","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":""}]}]}