{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CLARENCE E ROBERTS","gend":0,"add":"229   SHAMROCK DRIVE","city":"DANVILLE","state":"VA","zip":245414914,"dob":"1974-01-24","age":"","mstatus":"","insh":11015469,"cliId":"3N45V40NG78","pno":4347099145,"cno":"","email":"","ename":"","eno":"","pphy":"ALABANZA, THOMAS M","ppno":4347914648,"pcpadd":"990 Main St","pcpcity":"Danville","pcpstate":"VA","pcpzip":245411801,"pcpcounty":"","pcpid":"P0060173","pcpname":"DRS T M ALABANZA AND VT FALGUI PARTNERS"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["E11.9","N18.4","I10","E11.621","L97.412","L97.422","L97.522","L97.322","I87.2","I89.0","I13.2","I50.9","E11.22","D64.9","Z79.4","Z83.3","L97.512","N18.6","A41.9","I50.23","J96.01","I13.0","N18.5","L97.428","L97.418","N17.9","E87.1","R18.8","E87.2","L03.116","L03.115","I42.8","E11.65","R06.02","R60.9","R10.0","Z03.818","N18.9","I42.0","E11.52","L97.518","L97.528","R60.1","L97.822","L97.819"],"date":["2020-09-21","2020-11-04","2020-09-21","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-26","2020-10-08","2020-10-08","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-22","2020-10-21","2020-10-14","2020-10-15","2020-10-14","2020-10-14","2020-10-16","2020-10-14","2020-10-16","2020-10-14","2020-10-14","2020-10-14","2020-10-14","2020-10-15","2020-10-18","2020-10-18","2020-10-18","2020-10-20","2020-10-26","2020-10-26"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["No","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":""}]}]}