{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY SEIBERT","gend":1,"add":"8218 FAIR ISLE TER","city":"CHESTERFIELD","state":"VA","zip":238389999,"age":"","mstatus":"","insh":22027803801,"cliId":"","pno":8047784783,"cno":"","email":"TERPDAVES@GMAIL.COM","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","dob":"1956-08-30"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M25.562","I10","Z82.49","M06.9","R41.3","I11.9","M06.09","M85.89","M54.2","Z79.899","Z68.25","G30.0","F02.80","          ","Z13.820","M85.80","Z78.0"],"date":["2019-11-12","2019-11-26","2019-11-26","2020-10-19","2019-11-13","2019-11-26","2020-04-06","2020-10-19","2020-01-03","2020-10-19","2020-02-18","2020-02-18","2020-02-18","2020-10-19","2020-10-19","2020-10-19","2020-10-19"]}},{"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":[["2020-01-17","456122830","NAMZARIC","28-10MG","","Select","Select",""],["2020-11-12","65862032904","ALENDRONATE","TAB 70MG   ","4","Select","Select",""],["2020-11-14","13668010390","DONEPEZIL","TAB 10MG   ","30","Select","Select",""],["2020-11-30","53746016960","MEMANTINE","TAB HCL 10MG  ","60","Select","Select",""],["2020-11-03","43598072101","HYDROXYCHLOR","TAB 200MG   ","60","Select","Select",""],["2020-03-18","68180024906","MEMANTINE HC","28MG ER","","Select","Select",""],["2019-09-26","69097015907","MELOXICAM","15MG","","Select","Select",""],["2020-11-14","68180072003","AMLODIPINE","TAB 5MG   ","30","Select","Select",""],["2019-10-11","70461031903","FLUCLVX QUAD","2019-20","","Select","Select",""],["2020-10-02","49281042050","FLUZONE","QUAD INJ 2020-21  ","0.5","Select","Select",""],["2019-10-11","70461031903","FLUCLVX","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":""}]}]}