{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAYMOND G WALL","gend":0,"add":"130 CHARLOTTE AVE","city":"LA CROSSE","state":"VA","zip":239509999,"dob":"1958-04-06","age":"","mstatus":"","insh":11005341,"cliId":"5AQ5QV2YP52","pno":4347748639,"cno":4344473861,"email":"","ename":"","eno":"","pphy":"ACKERMAN, CHRISTOPHER J","ppno":4348480771,"pcpadd":"203 Sharp St","pcpcity":"Lawrenceville","pcpstate":"VA","pcpzip":238681615,"pcpcounty":"Brunswick","pcpid":"P0060059","pcpname":"LAWRENCEVILLE PRIMARY CARE"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["F84.0","F71","L60.3","B35.1","M20.40","K21.9","I11.9","E78.5","Z23","B02.9","D50.9","N39.0","E03.9","U07.1","G21.9","F22","F34.9","E66.9","F41.9","G47.00","G62.9","J30.9","K59.00","R03.0","R68.2","Z79.1","Z87.892","I51.7"],"date":["2020-08-05","2020-01-07","2020-01-07","2020-01-07","2020-01-07","2020-01-09","2020-07-23","2020-01-08","2019-10-08","2019-11-19","2020-01-08","2020-01-08","2020-07-23","2020-04-15","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2019-08-29","2020-07-23"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["No","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":""}]}]}