{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NATALIA P CARBAJAL-GOLDEN","gend":1,"add":"21205 WARRIOR  DRIVE","city":"CHESTERFIELD","state":"VA","zip":238032177,"dob":"2014-06-24","age":"","mstatus":"","insh":10167911,"cliId":"","pno":8048880025,"cno":"","email":"","ename":"","eno":"","pphy":"ARRIETA, MARY","ppno":"","pcpadd":"400 Southpark Blvd","pcpcity":"Colonial Heights","pcpstate":"VA","pcpzip":238342974,"pcpcounty":"","pcpid":"P9120213","pcpname":"SOUTHSIDE PEDIATRIC CENTER"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["K59.01","R10.84","K59.00","R10.13","R10.9","Z00.129","Z01.00","Z01.10","Z23","B34.9","R05","R50.9","J18.1","H66.91","R50.81","R07.1","H92.01","J98.4","H66.001","R09.81","H92.03","Z71.2"],"date":["2019-06-28","2019-06-28","2019-07-07","2019-07-07","2019-11-14","2020-08-06","2020-08-06","2020-08-06","2019-10-22","2019-11-14","2020-01-29","2019-11-21","2019-11-21","2019-11-21","2019-11-21","2019-11-21","2019-11-21","2019-11-22","2020-01-29","2020-01-29","2020-01-29","2020-09-10"]}},{"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":""}]}]}