{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANTONIO NASH","gend":0,"add":"501 MARIEL WAY","city":"CATALPA","state":"VA","zip":227019999,"dob":"1968-09-02","age":"","mstatus":"","insh":10005201,"cliId":"1D91YY3GN90","pno":5402292083,"cno":5405228891,"email":"","ename":"","eno":"","pphy":"BABAR, AHMAD","ppno":7037069897,"pcpadd":"501 MARIEL WAY","pcpcity":"CATALPA","pcpstate":"VA","pcpzip":227019999,"pcpcounty":"CULPEPER","pcpid":"P0129565","pcpname":"RIDGELINE PHYSICIAN SERVICES PLC"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["F44.5","R56.9","E11.9","R51","F41.9","F32.9","F43.10","Z98.890","Z79.899","Z79.4","F33.1","E11.65","F31.9","Z91.14","R68.89","R73.9","R10.9","G40.909","K52.9","J45.909","F33.2","R05","J02.9","K59.00","R10.84","R11.0","Z91.013","Z88.0","L02.11","I95.9","F17.200","F79","J35.8","E06.9","R22.1","F45.8","R13.10","R09.89","T17.200A","J03.90","R07.9","M54.5","Z79.891","R25.2","G62.9","K21.9"],"date":["2020-03-07","2020-03-07","2020-08-29","2020-05-09","2020-05-09","2020-03-27","2020-03-07","2020-03-07","2020-08-23","2020-08-22","2020-08-04","2020-09-10","2020-08-23","2020-03-21","2020-08-23","2020-03-27","2020-05-09","2020-08-23","2020-04-16","2020-08-23","2020-08-29","2020-03-30","2020-08-23","2020-04-16","2020-05-09","2020-04-16","2020-08-23","2020-08-23","2020-04-30","2020-04-17","2020-05-09","2020-09-10","2020-06-05","2020-06-05","2020-06-05","2020-08-22","2020-08-22","2020-08-22","2020-08-22","2020-08-23","2020-08-23","2020-09-19","2020-09-19","2020-09-19","2020-09-19","2020-09-19"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["No","Select","",false,""],["Yes","Select","",false,""],["No","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""],["Select","Select","",false,""]]]},{"t":"Self-assessment & 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":{"indx":[{"index":7,"values":[{"index":"No Ethnicity"}]}],"comment":[],"score":0}}]},{"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","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":[null,null,null,null,null,null,""]},{"a":[0,"","",0,{"txt":""},{"malnutrition":[]}]}]},{"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","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"icd-10","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a9":"","a10":[],"a11":""}]}]}