{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUAN J RIVERA-BLONDET","gend":0,"add":"828 AZALEA AVE","city":"RICHMOND","state":"VA","zip":232279999,"dob":"1954-03-31","age":"","mstatus":"","insh":11008409,"cliId":"4A36EX8UW59","pno":8049013169,"cno":8042333768,"email":"","ename":"","eno":"","pphy":"DONATO, ALPA PATEL","ppno":7579552828,"pcpadd":"885 Kempsville Rd Ste 320","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235023800,"pcpcounty":"HENRICO","pcpid":"P0133974","pcpname":"SENTARA FAMILY AND INTERNAL MEDICINE PHYSICIANS"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["B20","M54.9","M48.00","N40.1","L29.9","M25.552","M54.2","M25.50","Z71.6","R63.0","R10.32","Z01.812","Z20.828","Z12.11","D12.0","K57.30","B18.2","F17.210","Z79.899","K63.5","K57.90","Z86.010","D12.2"],"date":["2020-09-03","2020-09-03","2020-09-03","2019-12-10","2019-11-20","2019-12-06","2019-12-06","2020-02-07","2020-05-05","2020-07-07","2020-08-14","2020-09-17","2020-09-17","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2020-09-03","2020-09-21"]}},{"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":""}]}]}