{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHARLOTTE J ASH","gend":1,"add":"617 LEGRAND AVE","city":"WAYNESBORO","state":"VA","zip":229809999,"dob":"1929-02-24","age":"","mstatus":"","insh":11008364,"cliId":"5WY1TQ3JW05","pno":9126630518,"cno":"","email":"","ename":"","eno":"","pphy":"LEE, DONALD W","ppno":5409498241,"pcpadd":"428 S Magnolia Ave Ste 1","pcpcity":"Waynesboro","pcpstate":"VA","pcpzip":229803629,"pcpcounty":"WAYNESBORO CITY","pcpid":"P0125394","pcpname":"CFM ASSOCIATED PHYSICIANS WAYNESBORO"},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["Z00.00","Z12.31","M79.604","Z23","L30.9","I70.293","M79.675","M79.674","B35.1","H61.23","K57.90","K92.1","D62","D69.6","I10","E11.9","Z87.891","Z87.440","Z82.49","K59.1","R58","K62.5","S39.93XA","R19.5","R77.8","D64.9","K92.2","Z75.8","S60.429A","K52.9","R63.4","R79.9"],"date":["2019-10-03","2019-10-03","2019-10-03","2020-09-29","2020-01-20","2020-01-20","2020-01-20","2020-01-20","2020-01-20","2020-02-13","2020-06-16","2020-06-15","2020-06-14","2020-06-15","2020-06-24","2020-06-24","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-15","2020-07-23","2020-06-16","2020-06-24","2020-06-24","2020-09-29","2020-09-29","2020-09-29"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["No","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":""}]}]}