{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAIDER POLLINO","gend":0,"add":"409   MOORE STREET","city":"BRISTOL","state":"VA","zip":242014433,"dob":"2005-10-31","age":"","mstatus":"","insh":7672826,"cliId":"","pno":2764037237,"cno":"","email":"","ename":"","eno":"","pphy":"HOMMEL, JESSICA DOROTHY","ppno":"","pcpadd":"320 Steeles Rd","pcpcity":"Bristol","pcpstate":"TN","pcpzip":376209532,"pcpcounty":"","pcpid":"P9443175","pcpname":"HOLSTON MEDICAL GROUP PC"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J02.9","R11.2","J00","F41.8","B07.0","J10.1","R50.9","R52","F90.1","R05","R59.9","J01.90","R04.0","J35.03","G47.62","R25.2","M79.661","F90.9","F41.9","Z77.22","Z00.129","Z71.3","Z23","J35.1","R13.10","G89.18","H92.03","J06.9","N17.9","E87.6","R19.7","R10.31","R10.9","R10.11","B33.8","R10.10","R10.12","R19.8","R51","R09.81","S61.214A","M79.644","W26.8XXA","Y93.G3","S61.412A","S61.411A","H65.192"],"date":["2020-02-21","2020-01-16","2019-11-26","2019-06-05","2019-01-09","2019-01-15","2019-02-21","2019-01-15","2019-02-20","2020-01-22","2019-02-21","2020-03-13","2019-04-15","2019-04-04","2019-03-21","2019-03-21","2019-03-21","2020-01-01","2020-01-01","2020-08-08","2020-08-25","2019-04-02","2020-08-25","2019-04-04","2019-04-15","2019-04-15","2019-04-15","2019-12-03","2020-01-01","2020-01-01","2020-01-16","2020-01-01","2020-01-01","2020-01-16","2020-01-20","2020-01-16","2020-01-16","2020-01-16","2020-01-31","2020-03-13","2020-08-08","2020-08-08","2020-08-09","2020-08-08","2020-08-08","2020-08-09","2020-09-26"]}},{"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":""}]}]}