JSFiddle - React, Tailwind, and code Playground
by Brenton Strine
JavaScript
var sarObject =
[
{
provider: {
request_date: "requesteddategoeshere",
name: "providersnamegoeshere",
phone: "providernumbergoeshere",
address: "theprovideraddress",
city: "providerscity",
state: "",
zip: "",
contact: {
person: "",
phone: "",
fax: ""
}
},
client: {
name_last: "",
name_first: "",
name_middle: "",
alias: "",
gender: "",
dob: "",
ccs_ghpp: "",
phone: "",
mrn: "",
residence_addr: "",
residence_city: "",
residence_state: "",
residence_zip: "",
mailing_addr: "",
mailing_city: "",
mailing_state: "",
mailing_zip: "",
county: "",
language: "",
parent: "",
mother_name: "",
pcp: "",
pcp_phone: ""
},
diagnosis: [
"",
"",
""
],
insurance: {
healthy_families_flag: "",
healthy_families_plan: "",
medi_cal_flag: "",
medi_cal_no: "",
cin: "",
commercial_insurance_flag: "",
commercial_insurance_type: "",
commercial_insurance_name: ""
},
services: {
service_table: [
{
cpt_4: "",
description: "",
date_from: "",
date_to: "",
frequency: "",
duration: "",
units: "",
quantity: ""
},
{
cpt_4: "",
description: "",
date_from: "",
date_to: "",
...