{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" REFINNEJODANODLAM","gend":1,"add":"HSKREB 17EVIRD ERI","city":"STAFFORD","state":"VA","zip":225547867,"dob":"2005-01-19","age":"","mstatus":"","insh":"6418980","cliId":"","pno":"3861504880","cno":"","email":"","ename":"","eno":"","pphy":"CHAKURKAR, ASHWIN B","ppno":"","pcpadd":"4687 Pouncey Tract Rd","pcpcity":"Glen Allen","pcpstate":"VA","pcpzip":230595802,"pcpcounty":"","pcpid":"P9120115","pcpname":"CENTURY PEDIATRICS INC","pcpfaxno":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J30.9","J01.80","J06.9","J20.8","J02.9","J45.998","J45.901","J45.909","R07.81","R07.9","S23.41XS","M94.0","H10.9","H01.006","J32.9","H01.004","J45.990","R06.02","J45.991","E66.9","Z82.49","Z83.42","Z83.3","R00.2","Q21.1","G56.02","M79.632","M25.532","I49.8","L30.9","R11.2","E73.9","M25.552","M79.18","R10.9","Z11.3","Z11.4"],"date":["2018-10-18","2018-10-18","2019-08-07","2018-10-18","2018-10-18","2020-05-19","2020-05-19","2020-05-19","2019-03-26","2019-11-19","2019-03-26","2019-03-26","2019-05-08","2019-05-08","2019-08-07","2019-08-07","2019-10-08","2019-11-19","2019-11-19","2020-05-19","2020-05-19","2020-05-19","2020-05-19","2019-11-19","2020-05-19","2020-01-23","2020-01-23","2020-01-23","2020-05-19","2020-05-19","2020-05-19","2020-05-19","2020-07-31","2020-07-31","2020-07-31","2020-10-13","2020-10-13"]}},{"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":""}]}]}