{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LANETTE GUTLIFFE","gend":1,"add":"614 S ADAMS ST","city":"PETERSBURG","state":"VA","zip":238039999,"dob":"1987-03-13","age":"","mstatus":"","insh":11003390,"cliId":"6A12D24FX18","pno":8042150514,"cno":8047041666,"email":"","ename":"","eno":"","pphy":"MANSILLA, OLIVIA A","ppno":8043793100,"pcpadd":"360 Browns Hill Ct","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":231149500,"pcpcounty":"PETERSBURG CITY","pcpid":"P0124241","pcpname":"MANSILLA MEDICAL PRACTICE PC"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R10.2","Z11.3","R07.9","R00.2","N83.202","N83.292","Z34.92","N89.8","Z34.03","Z87.59","Z20.2","Z3A.30","F31.5","N94.10","O47.03","Z3A.35","O26.23","Z3A.38","Z22.330","O70.1","Z34.93","Z23","Z37.0","P59.9","F32.1","F32.9","F41.1","F43.10","F41.0","J40","J45.909","F41.9","F19.10","Z12.4","D64.9","J45.20","J30.9","F12.90","R06.02","R94.31","R68.89","F31.60","N76.0","Z68.24","B96.89","B00.9"],"date":["2020-07-28","2019-11-05","2019-04-02","2019-04-02","2019-11-19","2019-11-19","2018-05-11","2020-10-13","2018-05-15","2018-05-15","2018-05-15","2018-05-15","2019-10-25","2019-06-04","2018-06-22","2018-06-22","2018-07-10","2018-07-10","2018-07-10","2018-07-10","2018-07-10","2018-09-26","2018-07-10","2018-07-16","2019-07-29","2019-09-20","2019-08-04","2019-07-29","2019-07-29","2019-07-29","2019-09-23","2019-07-30","2019-07-30","2019-11-05","2019-08-22","2019-09-20","2019-09-20","2019-09-20","2018-09-26","2018-09-26","2018-10-02","2018-10-31","2020-07-28","2020-10-13","2020-07-28","2020-10-13"]}},{"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":""}]}]}