{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BELLA R SMALLS","gend":1,"add":"702   PROVIDENCE STREET","city":"STAFFORD","state":"VA","zip":225541780,"dob":"2017-04-15","age":"","mstatus":"","insh":8198174,"cliId":"","pno":7573032142,"cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["H65.191","J21.0","H66.002","J01.90","J10.1","Z00.129","Z13.0","Z13.88","K45.8","Z23","N30.01","Z77.22","H65.193","H92.01","R53.83","Z20.818","R30.0","L03.012","S60.10XA","S67.22XA","R10.9","J30.9","H10.45","L03.317","J02.9","J02.0","E86.0","R11.10","L02.31","H65.93","R50.9","L08.9","N30.91","Z95.818"],"date":["2018-09-20","2018-12-25","2020-02-24","2019-02-04","2019-02-04","2019-05-13","2019-05-13","2019-05-13","2019-05-13","2019-10-28","2019-06-05","2019-11-07","2019-06-30","2019-08-08","2019-08-08","2019-08-08","2019-09-15","2019-09-15","2019-09-15","2019-09-15","2019-10-15","2019-10-15","2019-10-15","2019-11-05","2020-02-24","2019-11-07","2019-11-08","2019-11-07","2019-11-07","2019-11-07","2020-02-24","2019-11-07","2019-11-07","2019-11-07"]}},{"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":""}]}]}