{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH L HITT","gend":1,"add":"329 WILLIAMS DR","city":"ORANGE","state":"VA","zip":"22960-9998","dob":"1964-09-02","age":"","mstatus":"","insh":"11010188","cliId":"","pno":5406727429,"cno":5407187256,"email":"","ename":"","eno":"","pphy":"BADARACCO, MARIA C","ppno":5406613004,"pcpadd":"661 University Ln Ste E","pcpcity":"Orange","pcpstate":"VA","pcpzip":229602243,"pcpcounty":"","pcpid":"","pcpname":"UVA ORANGE DIALYSIS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"329 WILLIAMS DR","madd2":"","madd3":"","mcity":"ORANGE","mstate":"VA","mzip":"22960-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","45802046564","KETOCONAZOLE ","2%","120.00","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.50","Select","Select",""],["","10702001801","OXYCODONE ","5MG","90.00","Select","Select",""],["","31722057330","ESOMEPRA ","40MG DR","90.00","Select","Select",""],["","59746036190","VALSARTAN ","80MG","45.00","Select","Select",""],["","00378064110","PREDNISONE ","10MG","21.00","Select","Select",""],["","68462065790","NORETH\/ETHIN ","1MG-5MCG","90.00","Select","Select",""],["","00173069600","ADVAIR ","250\/50","60.00","Select","Select",""],["","70377000415","SIMVASTATIN ","40MG","90.00","Select","Select",""],["","69097081312","GABAPENTIN ","100MG","180.00","Select","Select",""],["","68462010530","ONDANSETRON ","4MG","2.00","Select","Select",""],["","33332042110","AFLURIA ","2021-22","0.50","Select","Select",""],["","59310057922","PROAIR ","","25.50","Select","Select",""],["","00378932132","WIXELA ","250\/50","60.00","Select","Select",""],["","70377000612","ROSUVASTATIN ","5MG","90.00","Select","Select",""],["","68180030360","CEFUROXIME ","500MG","14.00","Select","Select",""],["","52268001201","SUPREP ","PREP KIT","354.00","Select","Select",""],["","68180012202","CEPHALEXIN ","500MG","20.00","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6.00","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}