{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TABITHA I MAHAJAN","gend":1,"add":"811 BURGESS ST","city":"MARTINSVILLE","state":"VA","zip":241129999,"dob":"1978-11-24","age":"","mstatus":"","insh":11004543,"cliId":"5M78V18ER29","pno":2766180234,"cno":2763404627,"email":"","ename":"","eno":"","pphy":"EGGLESTON-CLARK, VALENICA R","ppno":5404637628,"pcpadd":"1107 Brookdale St","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241124501,"pcpcounty":"HENRY","pcpid":"P0117725","pcpname":"CARILION MEDICAL ASSOCIATES"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["L60.0","B35.1","E10.49","M79.674","M79.675","E11.9","E78.00","Z79.899","R63.5","Z28.21","Z12.31","J11.1","R92.1","J20.9","R05","E11.65","R10.9","K42.9","E66.01","Z68.43","R22.0","T78.40XA","Z78.9","T78.40XD","R21","L50.9","K42.0","R07.89","R07.9","Z01.419","Z97.5","A08.4","H52.10","Z12.39","Z79.4","R31.9"],"date":["2020-09-22","2020-09-22","2020-09-22","2020-09-22","2020-09-22","2020-05-14","2020-07-17","2020-07-17","2019-01-14","2019-01-14","2020-08-04","2019-01-23","2019-02-11","2019-04-23","2019-04-23","2020-07-17","2019-05-08","2019-05-13","2019-05-13","2019-05-13","2019-06-03","2019-07-08","2019-05-15","2019-05-23","2019-05-23","2019-05-30","2019-08-16","2018-09-17","2018-09-17","2018-10-04","2018-10-04","2018-12-13","2020-05-14","2020-07-17","2020-04-07","2020-07-17"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["Yes","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":""}]}]}