{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHAKYRA A RAMIREZ","gend":1,"add":"5913 WILLOWBRANCH  DRIVE","city":"NORTH CHESTERFIEL","state":"VA","zip":232345929,"dob":"2011-12-23","age":"","mstatus":"","insh":7312786,"cliId":"","pno":8046878750,"cno":"","email":"","ename":"","eno":"","pphy":"ORTEGA RODRIGUEZ MEDICAL SERVICES INC","ppno":2393442367,"pcpadd":"3914 Meadowdale Blvd","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":232345547,"pcpcounty":"","pcpid":"P9058924","pcpname":"ORTEGA RODRIGUEZ MEDICAL SERVICES INC"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z91.038","Z23","N90.89","K59.00","R10.9","J02.9","J02.0","L25.9","J45.909","B35.4","J98.4","Z00.121","H52.203","M95.8","S42.002A","S42.022A","S49.92XA","W09.0XXA","S42.025A","M25.512","S42.025D","M25.521","W19.XXXA","S52.591A","S59.201A","V00.121A","S52.531A","M25.531","S52.531D","J06.9","R50.9","R51","S52.522A","W09.8XXA","S52.529A","S52.532A","M25.532","S52.532D"],"date":["2018-11-06","2018-11-06","2019-07-17","2019-01-02","2019-01-02","2020-02-24","2020-02-24","2019-07-03","2019-07-17","2019-07-03","2019-07-03","2019-07-17","2019-07-17","2019-09-08","2019-09-08","2019-09-08","2020-03-11","2019-09-08","2019-09-11","2019-10-30","2019-10-30","2019-11-05","2019-11-05","2019-11-05","2019-11-05","2019-11-05","2019-11-07","2019-12-11","2019-12-11","2020-01-08","2020-02-24","2020-02-24","2020-03-11","2020-03-11","2020-03-11","2020-03-18","2020-04-22","2020-04-22"]}},{"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":""}]}]}