{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELA SMITH","gend":1,"add":"9606 VIRGINIA CENTERWAY DR","city":"GLEN ALLEN","state":"VA","zip":230599999,"age":"","mstatus":"","insh":22028393701,"cliId":"","pno":8049010689,"cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","dob":"1967-12-29"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["H81.12","Z68.41","R05","J30.2","Z30.432","Z01.419","Z11.51","D25.9","R10.2","N95.1","Z12.4","D25.1","N83.291","N81.4","          ","Z01.810","Z01.818","Z01.812","Z20.828"],"date":["2020-01-30","2020-04-29","2020-08-31","2020-05-18","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-05-29","2020-05-29","2020-06-26","2020-06-10","2020-06-26","2020-11-14","2020-11-13","2020-11-13","2020-11-14","2020-11-14"]}},{"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":[["2020-05-05","59746000103","METHYLPRED","4MG","","Select","Select",""],["2020-11-28","74929690","SYNTHROID","TAB 112MCG   ","30","Select","Select",""],["2020-11-17","93505998","ATORVASTATIN","TAB 20MG   ","30","Select","Select",""],["2020-11-09","31722071390","PANTOPRAZOLE","TAB 40MG   ","30","Select","Select",""],["2020-05-18","54327099","FLUTICASONE","50MCG","","Select","Select",""],["2020-01-30","59746012106","MECLIZINE","25MG","","Select","Select",""],["2020-09-18","29300022019","MONTELUKAST","TAB 10MG   ","30","Select","Select",""],["2020-11-06","68645051054","HYDROCHLOROT","TAB 25MG   ","15","Select","Select",""],["2020-08-21","00173068220","VENTOLIN","HFA AER   ","18","Select","Select",""],["2020-11-19","42858010201","OXYCOD\/APAP","TAB 5-325MG   ","12","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":""}]}]}