{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARANN WILSON","gend":1,"currentgend":"","add":"1654 WILLOW ST","city":"DENVER","state":"CO","zip":"80220","dob":"1948-06-12","age":"","mstatus":"","insh":1020525854,"cliId":"","pno":"7207517190","cno":"7207517190","email":"","ename":"","eno":"","pphy":"LONG, JEREMY A","ppno":9702592022,"pcpadd":"1401 MAIN AVE,SUITE B","pcpcity":"DURANGO","pcpstate":"CO","pcpzip":"81301","pcpcounty":"","pcpid":"","pcpname":"DH PAV G COMPREH CARE MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1654 WILLOW ST","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80220","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1020525854","medicaidid":"","pcpFlag":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z029","Z1231","H524","H52223","C9200","D539","D696","E1143","B351","Z01818","H2512","R1031","H2511","H25811","M1712","H348120","H409","Z48810","E11649","D61818","T82868A","Z5112","C9202","Z5111","C9201","D701","L602","L409","G63","L84","Z794","M79674","M79675","Z23","H25812","H21512","Z961","H4052X0","H40001","Z98890","E162","Z743","E1165","T380X5A","Z7984","N179","N281","R42","R9089","Z452","D649","D72810","N949","E113591","E11628","H44712","E6601","E1139","H209","M25462","I7090","E113391","D469","I959","E1122","N189","R339","E860","T82898A","T451X5A","H401130","D352","H269","H25813","M79672","R2242","J9601","D849","R0902","R918","H47391","I10","H52221","E118","H4089","E113491","R0602","I700","E878","I498","R9431","H4312","H348122","K760","K429","K5730","I499","I088","D708","Z1211"],"date":["2026-01-16","2025-01-17","2024-04-03","2024-04-03","2026-01-27","2025-08-19","2025-11-19","2025-12-04","2025-03-04","2024-01-24","2023-04-27","2024-01-07","2024-02-26","2024-02-21","2024-05-24","2025-03-25","2024-10-31","2024-12-24","2025-09-25","2026-01-21","2025-10-22","2025-09-24","2025-09-17","2026-01-27","2026-01-23","2026-01-09","2025-03-04","2023-04-18","2023-04-18","2023-04-18","2025-09-28","2024-06-11","2025-03-04","2024-12-16","2023-04-27","2023-04-27","2025-03-11","2025-03-25","2025-03-25","2025-03-11","2025-05-15","2025-09-24","2025-09-26","2025-09-25","2025-09-15","2025-09-26","2025-09-14","2025-09-26","2025-09-24","2025-10-22","2025-11-19","2025-11-19","2022-08-23","2025-11-24","2023-08-22","2023-05-25","2024-07-17","2022-01-24","2023-08-25","2024-03-06","2024-03-06","2025-03-25","2025-08-06","2025-09-26","2025-09-26","2025-09-26","2025-09-26","2025-10-24","2025-10-22","2026-01-02","2023-06-28","2025-10-21","2022-05-25","2023-03-15","2023-04-18","2023-04-18","2025-09-15","2026-01-21","2025-09-09","2025-09-09","2022-09-27","2024-02-26","2023-07-13","2025-09-14","2022-05-25","2024-07-05","2025-05-15","2025-05-15","2025-09-24","2024-01-08","2024-01-08","2024-02-08","2024-09-20","2024-01-07","2024-01-07","2024-01-07","2025-05-20","2025-08-29","2025-07-09","2022-04-20"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","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":[]}]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","DORZOLAMIDE-TIMOLOL","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","PREMARIN","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of 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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":""}]}]}