{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TEODY BALISACAN","gend":0,"add":"1428 SKI LODGE RD","city":"VIRGINIA BEACH","state":"VA","zip":234539999,"dob":"1950-10-17","age":"","mstatus":"","insh":11011516,"cliId":"6V62FY9AD97","pno":7572753707,"cno":"","email":"","ename":"","eno":"","pphy":"OWENS, AMANDA K","ppno":7575070255,"pcpadd":"1950 Glenn Mitchell Dr Ste 304","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":234560048,"pcpcounty":"VIRGINIA BEACH CITY","pcpid":"P9634597","pcpname":"SENTARA PEDIATRIC PHYSICIANS"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["I10","M76.62","M25.572","R60.0","Z00.00","Z00.01","Z12.5","E55.9","R73.09","R82.3","Z13.6","Z13.1","E07.9","D58.2","R82.90","E78.5","E78.00","D16.9"],"date":["2020-02-13","2020-07-20","2020-07-30","2020-07-20","2020-07-30","2020-08-03","2020-08-03","2020-08-13","2020-08-13","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-13","2020-08-13"]}},{"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":"ASIAN\/PACIFIC"}]}],"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":""}]}]}