{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LANA G DAILEY","gend":1,"add":"239 ROCKY LANE","city":"DANVILLE","state":"VA","zip":245401664,"dob":"1953-02-01","age":"","mstatus":"","insh":11011162,"cliId":"9C13N99EW07","pno":4342502589,"cno":"","email":"","ename":"","eno":"","pphy":"WINFIELD II, ALBERT C","ppno":4347930700,"pcpadd":"239 ROCKY LANE","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":245401664,"pcpcounty":"DANVILLE CITY","pcpid":"P0060246","pcpname":"PROVIDENCE FAMILY AND SPORTS MEDICINE INC"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["M43.16","Z98.1","M54.5","Z47.89","M54.16","G89.29","M54.2","M47.26","M51.16","M48.061","M54.9","M47.812","R10.10","R11.0","Z12.11","K21.9","R19.4","N28.1","R93.2","M43.22","M54.12","M25.512","I10","E11.9","Z88.0","R13.10","M94.0","K62.5"],"date":["2020-03-04","2020-02-12","2020-02-12","2020-02-12","2020-02-12","2020-05-28","2020-05-31","2020-03-04","2020-05-28","2020-03-04","2020-03-24","2020-03-24","2020-06-02","2020-05-27","2020-05-12","2020-06-02","2020-06-02","2020-05-27","2020-05-27","2020-05-28","2020-05-28","2020-05-31","2020-05-31","2020-05-31","2020-05-31","2020-06-02","2020-06-02","2020-06-02"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["No","Select","",false,""],["No","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":""}]}]}