{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THALIA D MILLER","gend":1,"add":"4981 RICEVILLE RD","city":"GRETNA","state":"VA","zip":245579999,"dob":"1954-08-18","age":"","mstatus":"","insh":11011657,"cliId":"1EF3GH4AG78","pno":4347092494,"cno":4343355807,"email":"","ename":"","eno":"","pphy":"BURKHOLDER, BRENDEN","ppno":"","pcpadd":"2900 LAMB CIRCLE","pcpcity":"CHRISTIANSBURG","pcpstate":"VA","pcpzip":240736344,"pcpcounty":"PITTSYLVANIA","pcpid":"P9058480","pcpname":"CENTRA MEDICAL GROUP"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["J30.9","E11.9","I10","E11.59","G47.62","R25.2","H83.09","Z00.00","E78.5","G47.33","E66.01","Z79.82","Z79.84","Z79.899","Z88.5","M54.40","E55.9","L20.9","R79.89","Z12.11","Z86.010","Z83.71"],"date":["2020-04-10","2020-08-06","2020-08-06","2020-08-06","2020-04-10","2020-04-10","2020-04-10","2020-07-01","2020-08-06","2020-09-24","2020-07-01","2020-07-01","2020-07-01","2020-07-01","2020-07-01","2020-07-29","2020-08-06","2020-08-06","2020-08-27","2020-09-24","2020-09-24","2020-09-24"]}},{"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":{"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":""}]}]}