{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WARREN J MAYNARD","gend":0,"add":"5316 JEFFERSON DAVIS HWY #257","city":"FREDERICKSBURG","state":"VA","zip":224089999,"dob":"1955-07-29","age":"","mstatus":"","insh":11013940,"cliId":"5YP5QV5AX80","pno":5404298049,"cno":"","email":"","ename":"","eno":"","pphy":"ANSARI, NATHER B","ppno":5407859900,"pcpadd":"1075 GARRISONVILLE RD","pcpcity":"STAFFORD","pcpstate":"VA","pcpzip":225568600,"pcpcounty":"SPOTSYLVANIA","pcpid":"P0140793","pcpname":"PRIMARY AND URGENT CARE LLC"},{"a":{"indx":[{"index":7,"values":[{"index":"No Ethnicity"}]}],"comment":[],"score":0}},{"a":[]}]},{"t":"Curent Condition \/ Suspect Codes","q":[{"a":{"diag":["A41.9","I26.99","N13.6","E87.1","N39.0","K86.1","E87.2","N17.9","N25.81","Z11.59","I16.0","I10","B18.2","F10.10","R00.0","N28.1","K80.20","J12.9","R94.5","Z20.828","Z87.891","K76.0","E80.7","M79.10","N30.00","R74.8","R60.9","N13.2","N28.81","R06.02","N20.0","N20.1","Z45.2","R10.9","I27.82","N13.1","D41.21","Z79.01","Z87.19","Z86.19","Z88.8","N20.2","N28.89","Z01.818","Z87.442","K76.9","N45.1","K83.8"],"date":["2020-07-27","2020-10-27","2020-07-27","2020-07-27","2020-09-04","2020-07-21","2020-07-21","2020-07-24","2020-07-24","2020-09-02","2020-07-21","2020-10-16","2020-07-21","2020-07-21","2020-07-21","2020-07-24","2020-08-27","2020-07-21","2020-07-21","2020-07-21","2020-09-04","2020-07-21","2020-07-21","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-08-27","2020-07-24","2020-07-23","2020-09-04","2020-09-11","2020-07-24","2020-08-05","2020-08-05","2020-08-17","2020-08-17","2020-09-04","2020-08-17","2020-09-04","2020-09-04","2020-08-17","2020-08-17","2020-08-27","2020-09-04","2020-09-04","2020-09-15","2020-08-27"]}},{"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":[]}]},{"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":""}]}]}