{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RALPH SALYERS II","gend":0,"add":"16547 BROAD ST.","city":"SAINT PAUL","state":"VA","zip":242839999,"dob":"1976-07-13","age":"","mstatus":"","insh":11012497,"cliId":"7WY7QR7XY76","pno":2768701661,"cno":6062031145,"email":"","ename":"","eno":"","pphy":"EASTON, BRIAN T","ppno":4232395141,"pcpadd":"60 Town and Country Dr","pcpcity":"Lebanon","pcpstate":"VA","pcpzip":242665409,"pcpcounty":"WISE","pcpid":"P9058505","pcpname":"C HEALTH LEBANON"},{"a":[]},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["F43.10","F33.1","F33.2","F41.1","F11.21","F10.21","F41.0","M25.559","G89.29","F11.20","R00.2","F60.2","K61.1","K64.4","Z88.6","Z91.013","Z79.899","I10","G47.00","F17.210","F20.9","Z51.81","B18.2","I47.2"],"date":["2020-07-19","2020-08-03","2020-07-19","2020-08-14","2020-07-19","2020-07-19","2020-03-24","2020-03-24","2020-03-24","2020-09-22","2020-10-21","2020-08-14","2020-08-22","2020-08-22","2020-08-22","2020-08-22","2020-09-22","2020-08-22","2020-08-22","2020-08-22","2020-08-22","2020-09-22","2020-10-01","2020-10-21"]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings","q":[[["No","Select","",false,""],["No","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":""}]}]}