{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRAYAN A MENJIVAR-FIGUEROA","gend":0,"add":"6919   JEFFERSON DAVIS HIGHWAY","city":"RICHMOND","state":"VA","zip":232371547,"dob":"2006-11-27","age":"","mstatus":"","insh":4391548,"cliId":"","pno":8042719347,"cno":"","email":"","ename":"","eno":"","pphy":"GONZALES, PATRICIA D","ppno":"","pcpadd":"505 N 6TH AVE","pcpcity":"HOPEWELL","pcpstate":"VA","pcpzip":238602618,"pcpcounty":"","pcpid":"P9307367","pcpname":"INFANT JESUS CHILDRENS CLINIC PLC"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R10.31","Q67.5","L21.9","J06.9","K59.00","J02.9","R59.9","R50.9","E66.3","Z00.121","Z01.00","Z01.10","Z71.3","R68.89","R05","J00","J45.20","J30.9","H92.01","R07.9","Z13.1","Z13.220","E55.9","D64.9","Z13.29","R94.5","E88.81","E78.00","S93.602A","M41.125","H66.002","Q82.8","L29.8","L21.8","S82.425A","X50.1XXA","S89.312A","S93.402A","J02.0","S89.319D","M79.672","R26.81","J10.1","A08.4","R11.2","H10.45","Z23"],"date":["2018-12-11","2018-12-11","2019-09-21","2020-10-09","2018-12-28","2019-02-22","2019-02-12","2019-11-20","2020-02-13","2020-02-13","2020-02-13","2019-02-12","2019-02-12","2020-02-13","2019-02-16","2019-02-16","2019-09-21","2019-05-04","2019-05-04","2019-05-04","2019-05-18","2019-05-18","2019-05-30","2019-05-18","2019-05-18","2019-05-30","2019-05-30","2019-05-30","2019-06-17","2020-07-21","2020-10-09","2019-11-13","2019-11-13","2019-11-13","2019-11-13","2019-11-13","2020-01-13","2019-11-20","2019-11-20","2020-01-02","2020-01-02","2020-01-02","2019-12-25","2020-01-13","2020-01-13","2020-02-13","2020-10-09"]}},{"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":[]},{"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":""}]}]}