{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBRA S BROCK","gend":1,"add":"514 WINDERMERE DR","city":"CULPEPER","state":"VA","zip":227019999,"dob":"1960-07-11","age":"","mstatus":"","insh":11007206,"cliId":"3WM8HP6GV34","pno":5403214608,"cno":"","email":"","ename":"","eno":"","pphy":"WILLIAMS, OSTRANDA L","ppno":5408258381,"pcpadd":"633 Sunset Ln","pcpcity":"Culpeper","pcpstate":"VA","pcpzip":227013959,"pcpcounty":"CULPEPER","pcpid":"P9443083","pcpname":"UVA PEDIATRICS CULPEPER"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R79.89","R94.6","N39.0","I10","F29","F41.1","Z79.899","F33.42","F51.04","E70.0","F91.9","R41.89","G40.909","R63.0","G40.509","R56.9","R68.89","S00.83XA","M54.2","S09.90XA","W10.8XXA","S50.12XA","M54.9","W10.9XXA","Z04.3","M79.602","S63.502A","S53.492A","R53.1","R26.89","E87.6"],"date":["2019-05-02","2019-05-02","2020-09-04","2020-05-31","2019-08-02","2019-08-02","2020-05-31","2019-08-02","2019-08-02","2020-01-01","2019-10-30","2019-10-30","2020-05-31","2020-01-01","2020-01-01","2020-01-01","2020-01-01","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-06-02","2020-06-02","2020-09-04","2020-09-04","2020-09-04"]}},{"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":""}]}]}