{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" CIREMIULP","gend":0,"add":"ELPAM 422RD SLLIH ","city":"LYNCHBURG","state":"VA","zip":24502,"dob":"1989-02-03","age":"","mstatus":"","insh":"1008110*32","cliId":"","pno":"24\/4343417-6","cno":"","email":"","ename":"","eno":"","pphy":"Abdel Shaheed, Samir","ppno":"434\/455-5330","pcpadd":"3925 Portsmouth Boulevard","pcpcity":"Chesapeake","pcpstate":"VA","pcpzip":24502,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"Medicaid","lob":"M4","region":"WESTERN\/ CHARLOTTESVILLE","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":["E11.9","I10.","R11.2","Z91.018","Z71.9","M25.561","K21.9","R11.10","R76.8","K44.9","Z00.01","Z13.29","Z71.3","K80.50","F39.","F41.9","F84.0","Z13.39","Z13.31","E13.43"],"date":["2022-10-04","2022-10-04","2021-05-10","2021-05-10","2021-05-10","2022-02-18","2022-10-04","2020-05-06","2020-05-06","2020-05-06","2021-08-02","2020-08-27","2021-02-25","2021-02-25","2022-08-01","2020-05-06","2022-08-01","2022-08-01","2022-08-01","2020-04-29"],"priorHcc":["","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"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":""}]}]}