{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAUL W BRENNAN","gend":0,"add":"PO BOX 651","city":"VIRGINIA BEACH","state":"VA","zip":234510651,"dob":"1947-06-20","age":"","mstatus":"","insh":11016108,"cliId":"9TG9EA1JW21","pno":7574073811,"cno":"","email":"","ename":"","eno":"","pphy":"DOWDY, ROBERT L","ppno":7574137900,"pcpadd":"1024 First Colonial Rd","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":234543074,"pcpcounty":"VIRGINIA BEACH CITY","pcpid":"P0152211","pcpname":"SENTARA FAMILY MEDICINE PHYSICIANS"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R64","C10.9","G89.3","J95.00","D50.9","Z93.1","J44.9","D64.9","R69","C10.8","C77.9","J69.0","E04.1","Z93.0","R63.4","C80.0","R53.1","M62.81","J95.09","C80.1","F43.20","J96.10"],"date":["2020-10-27","2020-10-21","2020-10-27","2020-10-21","2020-10-05","2020-10-14","2020-10-27","2020-10-08","2020-10-14","2020-10-14","2020-10-14","2020-10-15","2020-10-14","2020-10-14","2020-10-15","2020-10-26","2020-10-15","2020-10-26","2020-10-15","2020-10-16","2020-10-21","2020-10-27"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["Yes","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":""}]}]}