{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACOB ROBERTSON","gend":0,"add":"1617   DAM TOWM ROAD","city":"FORT DEFIANCE","state":"VA","zip":244372103,"dob":"1994-07-30","age":"","mstatus":"","insh":11001294,"cliId":"6NR8ND4TH20","pno":5402904508,"cno":5402927192,"email":"","ename":"","eno":"","pphy":"BUCKWALTER, VICTOR LEE","ppno":5404334913,"pcpadd":"1151 Keezletown Rd Ste 101","pcpcity":"Weyers Cave","pcpstate":"VA","pcpzip":244862337,"pcpcounty":"AUGUSTA","pcpid":"P0117820","pcpname":"CARILION FAMILY MEDICINE WEYERS CAVE"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R63.2","R63.5","F70","F90.2","F80.2","F41.9","F82","H54.7","G80.9","F80.0","R29.818","R29.898","M62.81","F84.0","Z23","R27.8","M62.9","M26.603","R47.1","R20.1","R07.89","I10","R07.9","R51","J02.9","R20.9","Z88.2","Z91.018","Z91.010","Z91.02","R05","R26.9","G25.81","R48.2","F90.9","Q99.9","F90.0","F80.1","M79.672","M79.661","M79.662","G47.9"],"date":["2019-08-07","2019-08-07","2020-08-19","2020-08-19","2020-08-19","2020-08-19","2020-08-19","2019-08-07","2019-08-20","2019-08-20","2018-10-16","2018-10-16","2018-10-16","2019-07-10","2018-10-02","2018-04-17","2018-04-10","2018-04-10","2018-04-10","2018-04-17","2019-01-04","2019-01-04","2019-01-04","2019-01-04","2019-01-04","2020-08-19","2019-01-04","2019-01-04","2019-01-04","2019-01-04","2019-04-12","2019-04-15","2020-08-19","2019-04-15","2019-04-15","2019-04-15","2019-07-10","2019-07-10","2018-07-27","2020-08-19","2020-08-19","2020-08-19"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["No","Select","",false,""],["No","Select","",false,""],["No","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":""}]}]}