{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EDDIE HANEY","gend":0,"add":"PO BOX 91","city":"BARBOURSVILLE","state":"VA","zip":229239999,"dob":"1947-07-19","age":"","mstatus":"","insh":11000209,"cliId":"9T80DQ9CX45","pno":5408327796,"cno":"","email":"","ename":"","eno":"","pphy":"DEN HARTOG, JULIE R","ppno":5406613004,"pcpadd":"661 University Ln","pcpcity":"Orange","pcpstate":"VA","pcpzip":229602243,"pcpcounty":"ORANGE","pcpid":"P0060357","pcpname":"UNIVERSITY PHYSICIAN ORANGE"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["B07.9","L57.0","D48.5","C44.629","L82.1","L57.8","F17.200","D22.9","E11.9","I10","E78.5","Z72.0","R09.89","I49.9","M10.9","H61.21","R01.1","C44.622","Z85.828","Z08","H60.501","M1A.9XX0","H66.90","H61.22","H61.20","L85.8","L53.8"],"date":["2020-07-14","2020-07-14","2020-07-14","2019-01-09","2019-07-09","2019-07-09","2019-07-09","2019-07-09","2020-06-01","2020-06-01","2019-12-02","2018-02-19","2018-02-19","2019-02-27","2019-02-27","2019-02-27","2019-02-27","2018-05-15","2020-07-14","2020-07-14","2019-08-26","2020-06-01","2019-08-26","2019-08-26","2019-12-02","2020-07-14","2020-07-14"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["Yes","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":[]}]},{"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":""}]}]}