{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRIA M WILSON","gend":1,"add":"9245 HANOVER CROSSING DR.","city":"MECHANICSVILLE","state":"VA","zip":231163995,"dob":"2014-05-07","age":"","mstatus":"","insh":7809586,"cliId":"","pno":8045723039,"cno":"","email":"","ename":"","eno":"","pphy":"ESSAH, PAULINA","ppno":"","pcpadd":"719 N 25th St","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232236539,"pcpcounty":"","pcpid":"P0149257","pcpname":"BON SECOURS INTERNAL MEDICINE OF ASHLAND"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J06.9","N39.0","R11.10","R05","J34.89","R29.898","H53.023","Z00.129","E30.1","E27.0","Z68.54","S81.819A","W17.89XA","Y93.89","Y92.003","S71.111D","X58.XXXD","Z48.02","R11.2","K21.9","Z23"],"date":["2018-12-19","2018-12-19","2020-09-17","2020-09-17","2018-12-19","2019-02-13","2019-11-22","2020-09-21","2019-08-30","2019-09-25","2020-09-21","2019-10-25","2019-10-25","2019-10-25","2019-10-25","2019-11-09","2019-11-09","2019-11-09","2020-09-17","2020-09-21","2020-09-21"]}},{"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":""}]}]}