{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT M HOWARD JR","gend":0,"add":"282 SHILOH AVE","city":"WAYNESBORO","state":"VA","zip":229809999,"dob":"1971-11-18","age":"","mstatus":"","insh":11006293,"cliId":"1WN3JQ9VV95","pno":5408360977,"cno":5409424478,"email":"","ename":"","eno":"","pphy":"TAYLOR, ROBERT P","ppno":5409498241,"pcpadd":"25 NORTHRIDGE LANE","pcpcity":"LEXINGTON","pcpstate":"VA","pcpzip":244503399,"pcpcounty":"WAYNESBORO CITY","pcpid":"P0125394","pcpname":"CFM ASSOCIATED PHYSICIANS WAYNESBORO"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["F20.9","Z79.899","I10","E78.2","R73.01","R60.9","E66.01","Z87.891","E87.6","Z23","E11.65","N18.3","Z68.43","R79.89","N18.31","Z12.5","Z80.42"],"date":["2020-10-30","2020-02-11","2020-10-26","2020-06-26","2019-10-01","2019-08-02","2020-05-13","2020-05-13","2020-06-26","2019-11-06","2020-10-26","2020-08-06","2020-05-13","2020-08-06","2020-10-26","2020-10-26","2020-10-26"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","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":""}]}]}