{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"F W  CIRERS SEKLWO","gend":0,"add":"RAG 1173EVA DNAL","city":"RICHMOND","state":"VA","zip":23222,"dob":"1962-12-04","age":"","mstatus":"","insh":"0972210*21","cliId":"","pno":"25\/4085542-2","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23222,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS SPORTS MEDICINE & PRIMARY CARE","plan":"OHP","program":"Medicaid","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","E78.5","Z79.899","Z12.5","Z91.19","R81.","N52.9","I10.","E11.9","Z23.","Z68.31","R51.9","H53.8","Z76.0","H00.012","R03.0","D64.9","R80.9","Z72.0","M79.672"],"date":["2021-06-18","2021-06-18","2021-06-18","2021-06-18","2021-06-18","2020-07-20","2020-07-28","2020-02-04","2020-05-12","2020-02-04","2020-02-04","2021-01-08","2021-01-08","2021-01-08","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-07-27","2020-07-27"],"priorHcc":["","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}