{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILBERT A CHURCH","gend":0,"add":"511 AUTUMN WOOD DR","city":"KEYSVILLE","state":"VA","zip":239479999,"dob":"1949-04-12","age":"","mstatus":"","insh":11005647,"cliId":"3YV8GG0DX53","pno":4347369435,"cno":4342650594,"email":"","ename":"","eno":"","pphy":"PRUITT, DAVID E","ppno":4343928177,"pcpadd":"3510 Anderson Hwy","pcpcity":"Powhatan","pcpstate":"VA","pcpzip":231395846,"pcpcounty":"CHARLOTTE","pcpid":"P9338916","pcpname":"CENTRA MEDICAL GROUP"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["S91.301A","I12.9","G62.9","R20.2","K21.9","J44.9","Z72.0","N18.2","N18.9","I25.10","L03.115","L97.519","I10","R26.2","L30.9","S14.109S","Z90.79","Z79.02","Z79.82","Z87.891","Z83.3","Z84.1","M79.89","L03.90","T81.89XA","L97.509","Z51.89","I73.9","I42.9","N25.81","N18.3","E79.0","M79.672","M79.671","J30.9","H61.22","Z91.81","M86.9","R23.8","L53.9","S91.301D","Z23","N17.9","D63.1","E83.42","Q80.9","I11.9","E11.621","K14.0","E11.22","E11.40","E78.5","D50.9","E04.1","N18.30","L97.518","I87.2","B36.9"],"date":["2019-11-01","2020-10-05","2020-10-09","2019-04-02","2020-10-09","2020-10-09","2019-04-02","2019-07-24","2019-07-29","2020-10-09","2020-04-06","2020-06-29","2020-10-09","2020-06-29","2019-05-13","2019-05-13","2019-05-13","2019-05-13","2020-10-05","2020-10-09","2019-05-13","2019-05-13","2020-10-09","2020-02-24","2019-05-16","2019-07-12","2019-07-19","2020-10-05","2020-08-11","2020-10-05","2020-09-05","2020-01-23","2019-08-08","2020-03-05","2019-08-08","2019-03-04","2020-10-05","2020-02-25","2019-11-01","2019-11-01","2019-11-26","2019-11-26","2020-02-24","2020-02-24","2020-02-25","2020-02-24","2020-03-02","2020-03-05","2020-03-05","2020-03-05","2020-03-05","2020-10-09","2020-04-01","2020-08-31","2020-10-05","2020-10-05","2020-10-05","2020-10-09"]}},{"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":""}]}]}