{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LEA S SHIFFLETT","gend":1,"add":"1808 THIRD STREET","city":"WAYNESBORO","state":"VA","zip":229804245,"dob":"2012-03-21","age":"","mstatus":"","insh":7337375,"cliId":"","pno":5404511162,"cno":"","email":"","ename":"","eno":"","pphy":"PUMPHREY, SARAH","ppno":5409320980,"pcpadd":"57 Beam Ln Ste 202","pcpcity":"Fishersville","pcpstate":"VA","pcpzip":229392350,"pcpcounty":"","pcpid":"P9059124","pcpname":"UVA AUGUSTA PEDIATRICS"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["S52.522A","H66.92","J02.9","J02.0","J06.9","R50.9","J98.01","R05","J22","R35.0","H66.002","Z23","K59.01","N76.0","E30.1","Z00.129","F41.9","J45.30","E27.0","E30.9","F41.1","R15.9","N30.01"],"date":["2018-11-14","2018-11-21","2019-01-22","2019-01-22","2019-11-07","2019-01-22","2019-02-28","2019-02-28","2019-03-27","2019-11-07","2019-11-07","2019-11-07","2019-11-07","2019-11-07","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-12","2019-12-13","2020-06-08","2020-06-08","2020-09-22"]}},{"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":""}]}]}