{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HALEIGH G COMBS","gend":1,"add":"PO BOX 621","city":"DAMASCUS","state":"VA","zip":242360621,"dob":"2005-05-06","age":"","mstatus":"","insh":7868736,"cliId":"","pno":2762746580,"cno":"","email":"","ename":"","eno":"","pphy":"POTE, DOUGLAS A","ppno":"","pcpadd":"636 S Monte Vista Dr","pcpcity":"Glade Spring","pcpstate":"VA","pcpzip":243402712,"pcpcounty":"","pcpid":"P9058865","pcpname":"MSMG FP GLDE"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F43.25","F90.2","M25.562","M25.552","Q79.6","S39.011A","H10.31","L42","F32.9","F43.10","R45.851","L23.9","F32.1","S82.65XA","S99.912A","Y93.44","R69","X50.0XXA","S82.832A","W19.XXXA","S83.105A","W18.30XA","X58.XXXA","S83.005A","S89.92XA","X50.1XXA","Y93.9","Y92.219","Z03.89"],"date":["2019-06-04","2019-05-21","2019-12-11","2019-01-09","2019-01-09","2019-01-14","2019-01-23","2019-02-10","2019-05-23","2019-05-02","2019-04-17","2019-04-22","2019-05-27","2019-11-11","2019-11-11","2019-11-11","2019-11-11","2019-11-11","2019-11-12","2019-11-25","2019-11-19","2019-11-19","2019-11-19","2019-11-25","2019-11-19","2019-11-19","2019-11-19","2019-11-19","2019-11-19"]}},{"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":""}]}]}