{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NYMIR BURWELL","gend":0,"add":"1551 LAFAYETTE BOULEVARD NW","city":"ROANOKE","state":"VA","zip":240173341,"dob":"2019-02-27","age":"","mstatus":"","insh":10171480,"cliId":"","pno":5405378795,"cno":"","email":"","ename":"","eno":"","pphy":"GREGORY, DAVID S","ppno":"","pcpadd":"2323 Memorial Ave","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245012652,"pcpcounty":"","pcpid":"P0117344","pcpname":"CARILION FAMILY MEDICINE ROANOKE SALEM"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z38.00","Q22.8","Q25.0","Q21.1","Z23","Z01.10","Z41.2","I07.1","Z00.111","I36.1","I31.3","Z00.121","K59.00","K90.49","J06.9","R29.898","B37.0","J18.9","Z00.129","H10.31","R09.81","H10.9","B09","B37.9","R21","Z29.3"],"date":["2019-03-01","2019-02-27","2019-04-08","2019-08-20","2020-05-01","2019-02-28","2019-02-28","2019-03-01","2019-03-12","2019-04-08","2019-04-08","2019-08-20","2019-04-16","2019-04-16","2020-02-24","2019-08-20","2020-05-01","2019-10-29","2020-06-05","2019-12-08","2019-12-08","2019-12-11","2020-02-28","2020-03-12","2020-04-01","2020-05-01"]}},{"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":""}]}]}