{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ECIRTAPEGIAP E ","gend":1,"add":"NOSYARG 21741 TPA TS ","city":"NORFOLK","state":"VA","zip":23523,"dob":"1969-11-13","age":"","mstatus":"","insh":"4901610*79","cliId":"","pno":"09\/4083501-4","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"757\/627-6220","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":23523,"pcpcounty":"","pcpid":"","pcpname":"Hague Medical Associates","plan":"OHP","program":"Medicaid","lob":"M4","region":"TIDEWATER","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":["F11.20","S46.911A","I10.","E11.9","L30.9","J45.20","J30.2","Z76.89","F17.200","E66.9","NO DATA","G89.29","K80.20","Z23.","R10.13","K80.10","F17.210","Z79.84","Z79.899","Z88.0","M25.511"],"date":["2022-11-21","2021-01-30","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-06-21","2022-07-05","2021-09-08","2022-06-21","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2022-07-05","2021-02-05"],"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":[]}},{"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":""}]}]}