{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PEGGY L WASHINGTON","gend":1,"add":"1000   DRY BREAD ROAD","city":"EMPORIA","state":"VA","zip":238475920,"dob":"1953-07-08","age":"","mstatus":"","insh":11002937,"cliId":"9A94X54GA98","pno":4345942837,"cno":"","email":"","ename":"","eno":"","pphy":"SQUIRE, ROBERT HALL","ppno":4343484680,"pcpadd":"511 Belfield Dr","pcpcity":"Emporia","pcpstate":"VA","pcpzip":238471217,"pcpcounty":"GREENSVILLE","pcpid":"P0125808","pcpname":"SOUTHSIDE PHYSICIAN NETWORK LLC"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R91.8","I51.7","R93.8","H40.1131","H40.10X1","H25.13","I10","E78.5","Z00.00","Z12.31","H01.119","H57.12","H01.006","H10.32","E11.9","Z79.899","Z86.73","I16.0","R22.31","W19.XXXA","F41.9","W18.30XA","Y93.01","Y92.9","N17.9","I50.32","I13.0","E11.22","S00.93XA","E78.00","E11.65","N18.3","E83.42","S00.03XA","W01.198A","Z86.79","I67.1","I50.9","Z03.89","I12.9","N18.4","E87.1","R07.9","R07.89","S09.90XA","R53.81","M79.9","J10.1","Z20.828","R10.10","I63.50","R50.9","R06.2","R05","N18.9","E89.0"],"date":["2018-02-09","2018-02-09","2018-02-09","2019-03-07","2019-03-07","2019-03-07","2020-04-24","2020-04-24","2019-03-13","2019-03-29","2018-04-01","2018-04-01","2018-04-01","2018-04-01","2020-04-24","2020-02-04","2020-02-04","2019-11-05","2019-11-04","2019-10-29","2019-11-07","2019-10-30","2019-10-30","2019-10-30","2019-11-03","2019-10-30","2019-10-30","2020-02-04","2019-10-30","2019-10-30","2019-11-07","2019-10-30","2019-11-07","2019-10-30","2019-10-30","2019-11-03","2019-11-01","2019-11-01","2019-11-04","2020-02-04","2019-11-07","2019-11-18","2019-12-09","2020-01-14","2019-10-28","2019-10-28","2019-10-29","2020-02-04","2020-04-24","2020-04-24","2020-04-24","2020-04-24","2020-02-04","2020-02-04","2020-02-04","2020-02-04"]}},{"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":[]}]},{"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":""}]}]}