{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CRYSTAL M PALENSKI","gend":1,"add":"3058 MANSFIELD RD","city":"AYLETT","state":"VA","zip":230099999,"dob":"1981-06-30","age":"","mstatus":"","insh":11013831,"cliId":"1YH1HE2HE28","pno":8048016781,"cno":"","email":"","ename":"","eno":"","pphy":"KOEHN, DEBORAH A","ppno":8045608950,"pcpadd":"9000 Stony Point Pkwy","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232351900,"pcpcounty":"KING WILLIAM","pcpid":"P0060137","pcpname":"VCUHS THE PARK AT STONY POINT"},{"a":{"indx":[{"index":0}],"comment":[],"score":0}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["F11.20","F11.288","F33.2","N39.0","F12.20","Z91.5","M79.7","E11.9","K21.9","F17.210","G25.71","Z76.0","I10","J45.909","G89.29","M54.5","F41.9","F32.9","F12.90","Z79.899","M47.816","F19.20","Y90.9","F10.239","G40.909","F11.23","R11.0","F19.939","G47.00","F99","F17.200","R45.0","F33.1","F41.0","G89.4","F19.10","Z11.59","F41.1","Z01.419","Z11.51","Z87.42","J06.9","R09.89","R05","J02.9","B97.89","Z20.828","R13.10","R63.4","Z79.84"],"date":["2020-10-21","2020-06-01","2020-06-01","2020-06-01","2020-06-01","2020-06-01","2020-10-07","2020-10-07","2020-06-01","2020-09-30","2020-06-01","2020-06-05","2020-09-30","2020-09-30","2020-09-30","2020-09-30","2020-09-30","2020-10-07","2020-10-07","2020-06-09","2020-06-12","2020-06-18","2020-06-15","2020-06-15","2020-09-30","2020-06-17","2020-10-07","2020-06-17","2020-06-17","2020-06-23","2020-09-30","2020-07-07","2020-07-31","2020-07-31","2020-07-31","2020-07-23","2020-07-23","2020-07-25","2020-07-31","2020-07-31","2020-07-31","2020-09-30","2020-09-30","2020-09-30","2020-09-30","2020-09-30","2020-09-30","2020-10-07","2020-10-07","2020-10-07"]}},{"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":[]}]},{"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":""}]}]}