{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HAYLEY G OSBORNE","gend":1,"add":"PO BOX 2711","city":"COEBURN","state":"VA","zip":242302711,"dob":"2009-08-07","age":"","mstatus":"","insh":8054763,"cliId":"","pno":2762071105,"cno":"","email":"","ename":"","eno":"","pphy":"DEEL, SAMUEL P","ppno":"","pcpadd":"310 3rd St NE","pcpcity":"Norton","pcpstate":"VA","pcpzip":242731137,"pcpcounty":"","pcpid":"P9059211","pcpname":"WELLMONT MEDICAL ASSOCIATES INC"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["T76.02XA","T76.22XA","T74.22XA","J30.1","H10.45","Z00.129","J06.9","R09.81","K52.9","R11.2","R06.02","R00.0","R07.9","R07.89","I49.5","F41.0","F32.1","R68.89","J02.0","R50.9","R53.83","R10.9","H66.91","H92.03","J02.9","K59.00","N39.0","H92.09","R07.0","R10.31","H40.053"],"date":["2019-01-05","2019-01-05","2019-01-08","2019-01-08","2019-01-08","2019-01-10","2019-01-10","2020-03-05","2019-02-07","2019-02-07","2019-03-07","2019-03-07","2019-06-06","2019-06-06","2019-03-07","2019-03-07","2019-06-28","2019-05-31","2020-10-05","2019-06-06","2019-06-06","2020-06-03","2019-12-16","2019-12-16","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","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":""}]}]}