{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TERESA PRESCOTT","gend":1,"add":"3724 HOSKINS DR","city":"GLEN ALLEN","state":"VA","zip":230609999,"age":"","mstatus":"","insh":22028442901,"cliId":"","pno":7034086844,"cno":"","email":"PRESCOTT1957@GMAIL.COM","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","dob":"1957-07-03"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["D68.59","Z86.711","Z51.81","J06.9","Z79.01","B97.89","Z68.20","H90.3","Z00.00","E78.00","M85.89","K52.9","G43.009","Z87.39","Z78.0","Z12.39","Z11.59","D48.5","D04.4","Z12.31","D22.9","L82.1","I78.1","Z85.828","L57.0","M81.0","K51.90","Z86.010","K56.609","D68.9","M79.7","L29.9","Z79.899","L90.5","Z12.39    ","Z68.20    ","K56.699","          "],"date":["2020-04-09","2020-03-16","2020-04-09","2019-12-02","2020-04-09","2019-12-02","2020-03-16","2020-09-21","2020-01-06","2020-01-06","2020-05-26","2020-01-07","2020-01-06","2020-05-26","2020-05-26","2020-01-06","2020-01-07","2020-05-26","2020-10-13","2020-05-26","2020-05-26","2020-05-26","2020-05-26","2020-10-29","2020-10-29","2020-05-26","2020-11-05","2020-11-05","2020-09-03","2020-11-05","2020-09-03","2020-07-28","2020-08-18","2020-08-18","2020-01-06","2020-01-06","2020-09-03","2020-11-05"]}},{"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":[["2020-11-02","72205000490","ROSUVASTATIN","TAB 20MG   ","30","Select","Select",""],["2020-05-06","832121800","JANTOVEN","7.5MG","","Select","Select",""],["2020-11-02","50458057930","XARELTO","TAB 20MG   ","30","Select","Select",""],["2020-01-20","29300011610","TOPIRAMATE","50MG","","Select","Select",""],["2020-07-28","51672136504","FLUOCIN ACET","0.01%","","Select","Select",""],["2020-07-29","51862036240","FLUOROURACIL","5%","","Select","Select",""],["2020-11-16","58160082311","SHINGRIX","INJ 50\/0.5ML   ","1","Select","Select",""],["2020-09-11","45802036862","IMIQUIMOD","CRE 0.05   ","12","Select","Select",""],["2020-10-14","65162077810","BUDESONIDE","CAP 3MG DR  ","30","Select","Select",""],["2020-09-23","70461032003","FLUCLVX","QUAD INJ 2020-21  ","0.5","Select","Select",""],["2020-07-28","51672136504","FLUOCIN","ACET SOL 0.0001  ","60","Select","Select",""],["2020-11-05","52268001201","SUPREP","BOWEL SOL PREP KIT ","354","Select","Select",""],["2020-11-05","68682011320","MESALAMINE","CAP 0.375GM   ","60","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":""}]}]}