{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CORTLAND W LESLIE","gend":0,"add":"31280 LEE HIGHWAY","city":"GLADE SPRING","state":"VA","zip":243404816,"dob":"2003-07-03","age":"","mstatus":"","insh":7547135,"cliId":"","pno":2766986257,"cno":"","email":"","ename":"","eno":"","pphy":"PHILLIPS, PAUL A","ppno":"","pcpadd":"16431 Wise St","pcpcity":"Saint Paul","pcpstate":"VA","pcpzip":242833537,"pcpcounty":"","pcpid":"P9443072","pcpname":"WPS PROVIDERS INC"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F90.2","F41.1","R68.89","E88.81","E55.9","R63.5","E30.0","R74.8","R79.89","K76.0","F31.9"],"date":["2019-10-07","2019-05-10","2019-05-10","2019-09-23","2019-09-23","2019-09-23","2019-03-05","2019-09-23","2019-09-23","2019-03-05","2020-10-07"]}},{"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":""}]}]}