{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARGIE M FORD","gend":1,"add":"1708 N 29TH ST","city":"RICHMOND","state":"VA","zip":232239999,"dob":"1949-06-22","age":"","mstatus":"","insh":11007750,"cliId":"8UY3X81AW85","pno":8046688202,"cno":"","email":"","ename":"","eno":"","pphy":"PEEL, CAROLYN A","ppno":8048285883,"pcpadd":"1708 N 29TH ST","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":232239999,"pcpcounty":"CHESTERFIELD","pcpid":"P0060154","pcpname":"VCUHS NELSON CLINIC"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["J18.1","R05","J20.9","E11.9","I10","K21.9","Z79.899","R91.8","N39.41","B35.3","J18.9","F32.1","Z87.891","F03.90","F20.9","F32.9","Z12.31","N63.0","R92.2"],"date":["2020-02-23","2020-02-23","2020-02-23","2020-02-23","2020-03-04","2020-02-23","2020-02-23","2020-02-23","2020-09-26","2019-08-21","2020-03-04","2020-09-20","2020-03-04","2020-03-04","2020-03-04","2020-04-01","2020-06-24","2020-07-14","2020-07-14"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["Yes","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":{"indx":[{"index":7,"values":[{"index":"No Ethnicity"}]}],"comment":[],"score":0}}]},{"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":""}]}]}