{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAFAA ALSOUFI","gend":1,"add":"4113 BREMNER BLVD","city":"HENRICO","state":"VA","zip":232289999,"age":"","mstatus":"","insh":22027937101,"cliId":"","pno":5717230883,"cno":"","email":"S_ALSOUFI@YAHOO.COM","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","dob":"1978-01-01"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z11.7","Z33.1","O09.521","O36.80X0","O99.211","E66.9","Z3A.01","O28.3","Z36.82","Z3A.13","O09.899","O34.12","D25.9","Z3A.15","Z36.83","O24.112","O24.312","Z3A.19","O09.522","O28.1","Z36.3","Z3A.22","Z3A.26","D18.1","H31.003","H52.7","O09.523","O24.410","Z3A.31","Z3A.33","O34.13","O36.63X0","O35.8XX0","Z3A.34","O24.419","O34.219","Z3A.36","Z3A.37","O24.415","Z3A.38","B37.9","O86.09","O13.5","N39.0","          ","O24.435"],"date":["2019-11-30","2020-08-12","2020-03-10","2020-01-22","2020-01-22","2020-01-22","2020-01-22","2020-03-26","2020-03-10","2020-03-10","2020-07-15","2020-06-10","2020-08-04","2020-03-26","2020-04-23","2020-04-23","2020-04-23","2020-04-23","2020-06-10","2020-05-13","2020-05-13","2020-05-13","2020-06-10","2020-07-15","2020-07-02","2020-07-02","2020-09-02","2020-08-04","2020-07-15","2020-07-29","2020-08-04","2020-09-02","2020-08-04","2020-08-04","2020-08-26","2020-08-19","2020-08-19","2020-08-26","2020-09-02","2020-09-02","2020-09-11","2020-09-11","2020-09-11","2020-09-29","2020-10-28","2020-10-28"]}},{"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":[["2020-02-10","17478076710","PROGESTERONE","200MG","","Select","Select",""],["2020-01-31","555088704","ESTRADIOL","2MG","","Select","Select",""],["2019-11-18","33332031901","AFLURIA QUAD","2019-20","","Select","Select",""],["2020-10-12","47781055201","LABETALOL","TAB 100MG   ","60","Select","Select",""],["2019-11-18","33332031901","AFLURIA","QUAD INJ 2019-20  ","0.5","Select","Select",""],["2020-09-04","68645056259","IBUPROFEN","TAB 600MG   ","40","Select","Select",""],["2020-09-04","42858000101","OXYCODONE","TAB 5MG   ","20","Select","Select",""],["2020-09-07","65162063609","PANTOPRAZOLE","TAB 20MG   ","60","Select","Select",""],["2020-09-11","65862042005","SMZ\/TMP","DS TAB 800-160  ","20","Select","Select",""],["2020-09-11","68308015215","NYSTATIN","POW 100000   ","30","Select","Select",""],["2020-09-24","70461032003","FLUCLVX","QUAD INJ 2020-21  ","0.5","Select","Select",""],["2020-11-12","93310905","AMOXICILLIN","CAP 500MG   ","21","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":""}]}]}