{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID CRAWLEY","gend":0,"add":"1212 CHARLTON AVE","city":"CHARLOTTESVILLE","state":"VA","zip":229025924,"dob":"1962-08-11","age":"","mstatus":"","insh":11004778,"cliId":"9GC6N15PD42","pno":4342204639,"cno":"","email":"","ename":"","eno":"","pphy":"CLEMONS, BRUCE D","ppno":4342444550,"pcpadd":"310 Old Ivy Way","pcpcity":"Charlottesville","pcpstate":"VA","pcpzip":229034896,"pcpcounty":"CHARLOTTESVILLE CITY","pcpid":"P0110915","pcpname":"MARTHA JEFFERSON MEDICAL ASSOCIATES"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["F33.1","Z01.810","R94.31","S83.242A","M22.42","M94.262","Z79.899","Z79.51","Z79.82","J44.9","Z79.84","Z88.0","Z88.8","Z91.013","F17.210","F32.9","F41.9","I11.0","I50.9","E11.42","M25.562","R68.89","K25.1","R19.8","K25.5","K25.9","K65.9","B37.89","E44.0","E11.9","I48.91","E78.5","E87.6","D72.829","Z79.1","K66.8","R07.9","R10.31","R11.10","R10.13","M17.0","S83.232A","S83.282A","Z71.6"],"date":["2020-09-30","2019-03-07","2019-03-07","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-12-17","2019-03-08","2019-03-08","2019-03-08","2019-03-08","2019-12-17","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-03-08","2019-03-11","2018-09-11","2019-09-24","2019-10-02","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2019-09-24","2018-12-14","2018-12-14","2018-12-14","2019-12-17"]}},{"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":""}]}]}