{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JACQUELINE C BLAND","gend":1,"add":"409   TURLINGTON  ROAD","city":"NEWPORT NEWS","state":"VA","zip":236062453,"dob":"1979-11-30","age":"","mstatus":"","insh":11009401,"cliId":"5KG4HX6WN03","pno":4348298604,"cno":"","email":"","ename":"","eno":"","pphy":"COCHRAN, DONALD","ppno":7573971246,"pcpadd":"640 North St","pcpcity":"Portsmouth","pcpstate":"VA","pcpzip":237042415,"pcpcounty":"NEWPORT NEWS CITY","pcpid":"P0140239","pcpname":"MD EXPRESS"},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["N30.00","R30.0","B37.9","M54.9","R10.2","R11.0","R19.7","R35.0","R39.15","F31.9","E11.9","I10","F20.0","F17.210","Z79.899","Z79.84","B00.9","Z11.3","N89.8","R03.0","B37.3","N30.01","E11.65","Z11.59"],"date":["2020-01-26","2020-05-17","2020-03-30","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2020-07-28","2020-02-28","2020-02-28","2020-07-28","2020-03-30","2020-02-28","2020-03-30","2020-02-28","2020-07-22","2020-03-30","2020-05-17","2020-09-21","2020-05-17","2020-07-22","2020-07-11","2020-07-22","2020-07-22"]}},{"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":""}]}]}