{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAMONTA FORD","gend":0,"add":"1221   DEWBERRY DRIVE","city":"FREDERICKSBURG","state":"VA","zip":224074881,"dob":"2004-01-17","age":"","mstatus":"","insh":7093018,"cliId":"","pno":7037195486,"cno":"","email":"","ename":"","eno":"","pphy":"KOST PHILLIPS, JENNIFER R","ppno":"","pcpadd":"331 Park Hill Dr","pcpcity":"Fredericksburg","pcpstate":"VA","pcpzip":224013375,"pcpcounty":"","pcpid":"P9443183","pcpname":"PREFERRED PEDIATRICS AT SNOWDEN INC"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z00.121","Z68.54","Z71.3","Z71.82","E66.3","Z13.89","M22.3X1","S72.321A","R10.2","S72.401A","Y93.61","Y92.9","Y99.9","W03.XXXA","S72.8X1A","W50.0XXA","Y92.89","Y93.89","S72.331A","W01.0XXA","Y92.321","S72.331D","M62.81","Z98.890"],"date":["2019-08-21","2019-08-21","2019-08-21","2019-08-21","2019-08-21","2019-08-21","2019-09-09","2019-09-10","2019-09-09","2019-09-10","2019-09-09","2019-09-09","2019-09-09","2019-09-09","2020-02-01","2019-09-09","2019-09-09","2019-09-09","2019-09-10","2019-09-10","2019-09-10","2020-02-11","2020-02-11","2020-02-11"]}},{"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":""}]}]}