{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SUSAN  M SHIFFLETT","gend":1,"add":"1112 N MAIN ST","city":"HARRISONBURG","state":"VA","zip":22802,"dob":"1976-05-27","age":"","mstatus":"","insh":"8557411*01","cliId":"","pno":"540\/830-0069","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":22802,"pcpcounty":"","pcpid":"","pcpname":"Carilion Family Medicine - Dayton","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":["E11.65","E66.9","E03.9","I10.","Z79.899","I21.4","I25.10","Z79.82","I25.83","Z23.","U07.1","Z68.33","R03.0","R11.0","R10.13","R11.2","N94.6","J30.2","J01.90","Z01.818","F32.1","R10.2","D25.1","N93.9","F32.0","Z86.16","Z98.890","Z88.0","Z88.8","E11.9","E78.5","Z79.890","M25.512","G89.29"],"date":["2021-11-01","2022-01-30","2022-02-25","2022-02-25","2022-02-25","2020-06-08","2021-11-01","2021-11-01","2021-11-01","2021-11-01","2022-01-30","2022-01-30","2022-01-30","2020-10-20","2020-10-22","2020-10-22","2022-02-25","2021-06-07","2021-06-07","2022-02-22","2021-11-01","2021-12-07","2021-12-07","2021-12-07","2020-12-30","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2021-07-15","2021-07-15"],"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":""}]}]}