{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SAMIRAH A ELLIS","gend":1,"add":"723   STURGIS DRIVE","city":"NORTH CHESTERFIEL","state":"VA","zip":232369999,"dob":"2003-05-05","age":"","mstatus":"","insh":6952600,"cliId":"","pno":8048883182,"cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F34.81","F41.9","O21.0","R10.9","Z3A.01","Z32.01","O21.9","O26.891","Z34.00","Z11.3","Z34.80","R01.1","O09.619","Z36.0","Q21.0","H66.43","R05","H66.91","O36.5930","Z3A.38","F91.9","Z36.2","Z3A.33","O36.5130","Z3A.34","F41.1","Z3A.35","Z3A.36","Z3A.37","Z37.0","K21.9","O99.283","O70.1","O80","Z3A.39","Z39.1","Z34.82","Z34.83","M79.641","S61.212A","S61.214A","W26.0XXA","S69.90XA","D16.11","Z01.411","N76.0","Z11.8","A56.02","Z71.89","Z30.430","Z32.02","S50.861A","R42","M79.601","N94.6","S42.411A","Z30.431","B96.89","Z20.2","N92.6"],"date":["2019-12-22","2018-09-26","2019-04-06","2019-04-06","2019-04-06","2019-04-06","2019-04-06","2019-04-06","2019-05-16","2020-06-16","2019-04-11","2019-04-11","2019-05-16","2019-05-16","2019-05-20","2019-09-16","2019-09-16","2019-09-16","2019-11-12","2019-11-10","2019-10-17","2019-10-09","2019-10-09","2019-11-07","2019-10-10","2019-10-17","2019-10-18","2019-10-24","2019-10-31","2019-11-12","2019-11-12","2019-11-12","2019-11-12","2019-11-12","2019-11-12","2019-11-15","2019-11-15","2019-11-15","2020-02-16","2020-02-16","2020-02-26","2020-02-16","2020-02-16","2020-02-26","2020-04-20","2020-08-17","2020-06-16","2020-06-16","2020-04-29","2020-06-16","2020-06-16","2020-06-25","2020-06-25","2020-07-11","2020-07-11","2020-07-11","2020-08-31","2020-08-17","2020-08-17","2020-08-31"]}},{"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":""}]}]}