{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ELEANOR M MCLAUGHLIN","gend":1,"add":"151   ROSE LANE","city":"APPOMATTOX","state":"VA","zip":245228050,"dob":"1930-08-27","age":"","mstatus":"","insh":11016439,"cliId":"7MJ6ME9QE89","pno":7327796778,"cno":4346642215,"email":"","ename":"","eno":"","pphy":"ALBERS, GREGG","ppno":4348468421,"pcpadd":"2811 Linkhorne Dr Ste A","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245033354,"pcpcounty":"APPOMATTOX","pcpid":"P9307464","pcpname":"PRIVIA MEDICAL GROUP LLC"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R53.81","E11.65","I63.9","W18.39XA","Y92.099","G93.41","Z20.828","N17.9","L03.116","E87.1","Z66","R47.81","R32","M62.81","E86.0","E11.69","E87.5","Z87.891","R53.1","R41.0","R39.81","I50.9","M19.90","R60.0","I10","D64.9","E87.6","R68.89"],"date":["2020-10-05","2020-10-12","2020-10-05","2020-10-05","2020-10-05","2020-10-27","2020-10-05","2020-10-27","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-10","2020-10-13","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-10","2020-10-10","2020-10-10","2020-10-10","2020-10-13","2020-10-28","2020-10-27","2020-10-28"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","",false,""],["No","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":""}]}]}