{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STAFFORD L ROSS","gend":0,"add":"900 RIVES RD","city":"MARTINSVILLE","state":"VA","zip":241129999,"dob":"1947-04-06","age":"","mstatus":"","insh":11008477,"cliId":"8DF3WU5CT87","pno":2768066512,"cno":2766322263,"email":"","ename":"","eno":"","pphy":"RUSZKOWSKI, RONALD J","ppno":2766667723,"pcpadd":"320 Hospital Dr","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241121900,"pcpcounty":"HENRY","pcpid":"P9058810","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES LLC"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R39.81","R15.9","Z99.3","R10.11","K80.20","K22.6","R11.10","K80.12","K80.10","K82.8","I73.9","I10","F10.21","Z87.891","Z89.511","Z89.422","Z79.899","Z12.2","R10.9","N20.0","N28.1","R07.9","R91.1","R06.00","R94.31","R06.02"],"date":["2020-10-15","2020-10-15","2020-10-15","2020-05-01","2020-04-28","2020-04-28","2020-04-28","2020-05-07","2020-05-11","2020-05-07","2020-05-07","2020-09-28","2020-05-07","2020-06-02","2020-05-07","2020-05-07","2020-05-07","2020-06-02","2020-04-28","2020-04-28","2020-04-28","2020-04-28","2020-10-03","2020-09-28","2020-09-28","2020-09-28"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["Yes","Select","",false,""],["Yes","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":""}]}]}