{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAULETTE J WILLIS","gend":1,"add":"2007 BROWN CIRCLE","city":"HAMPTON","state":"VA","zip":236639999,"dob":"1963-07-07","age":"","mstatus":"","insh":11007995,"cliId":"5Y46AP8PN73","pno":7575094603,"cno":"","email":"","ename":"","eno":"","pphy":"BAINES, ROBIN","ppno":7577265000,"pcpadd":"2007 BROWN CIRCLE","pcpcity":"HAMPTON","pcpstate":"VA","pcpzip":236639999,"pcpcounty":"HAMPTON CITY","pcpid":"P0142925","pcpname":"SENTARA MEDICAL GROUP"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["E66.9","E11.40","Z00.00","Z79.4","Z68.31","M50.322","M51.36","M43.02","M43.06","M65.879","R26.2","E11.42","M72.2","M76.62","M76.61","E03.9","Z47.1","M25.562","R68.89","Z96.652","E11.3211","H25.13"],"date":["2019-08-01","2019-11-06","2019-08-01","2019-11-06","2019-08-01","2019-10-16","2019-12-23","2019-12-23","2019-12-23","2020-02-17","2020-02-17","2019-12-20","2019-10-24","2020-02-17","2020-02-17","2019-11-06","2019-12-23","2020-03-16","2020-03-16","2020-03-16","2020-03-17","2020-03-17"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["Yes","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":{"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":""}]}]}