{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REBECCA L ROGERS","gend":1,"add":"210 MOUNTAIN VIEW RD","city":"MEADOWS OF DAN","state":"VA","zip":241209999,"dob":"1970-07-26","age":"","mstatus":"","insh":11013554,"cliId":"6FP6G88MK78","pno":2769528267,"cno":2763405264,"email":"","ename":"","eno":"","pphy":"TATE, GLEN E","ppno":2763982292,"pcpadd":"40 Wiley Dr","pcpcity":"Ferrum","pcpstate":"VA","pcpzip":240881100,"pcpcounty":"PATRICK","pcpid":"P9059108","pcpname":"TRI AREA COMMUNITY HEALTH CENTER AT LAUREL FORK"},{"a":{"indx":[{"index":7,"values":[{"index":"No Ethnicity"}]}],"comment":[],"score":0}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["R11.2","G43.009","R06.2","F31.9","M25.511","R20.2","R45.4","L03.115","Z53.29","J44.9","K21.9","F20.9","Z72.0","Z98.890","Z53.20","R21","R00.0","F32.9","J45.909","G25.81","F17.200","Z53.21"],"date":["2020-05-08","2020-05-08","2020-05-08","2020-09-14","2020-05-15","2020-05-15","2020-05-15","2020-09-15","2020-09-14","2020-09-14","2020-09-15","2020-09-14","2020-09-14","2020-09-14","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-15","2020-09-15"]}},{"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":[]}]},{"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":""}]}]}