{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FRANK KOHAKE","gend":0,"currentgend":"","add":"690 S ALCOTT ST","city":"DENVER","state":"CO","zip":"80219","dob":"1953-12-24","age":"","mstatus":"","insh":2000008692,"cliId":"","pno":"3034723732","cno":"3034723732","email":"","ename":"","eno":"","pphy":"DRUMRIGHT, BENJAMIN L","ppno":4124327469,"pcpadd":"4401 PENN AVE,","pcpcity":"PITTSBURGH","pcpstate":"PA","pcpzip":"15251","pcpcounty":"","pcpid":"","pcpname":"WESTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"690 S ALCOTT ST","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80219","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2000008692","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R569","E1165","R531","G9389","E1110","G939","G40909","F10929","I69920","R2990","I69918","Z743","G8384","I7090","R9089","I700","G40011","G0481","R930","G40901","G8929","M25551","L03011","C718","R001","I69351","G40109","E119","D696","E876","I10","F1090","R918","R161","K760","G40001","L089","S0990XA","W228XXA","S62521D","S61111D","W232XXD","R29810","R200","R471","I6523","I672","R29818","S62521B","M86441","X58XXXA","L608","R197","R42","T1490XA","S6701XD","E1151","H538","G40919","M7989","L720","F32A","F419","I63541","G40209","K7682","S61111A","R202","G928","R059","R29898","E162","Z043","Z7901","S62521A","W230XXA","W232XXA","F1010","H2513","R9401","R410","I6789","Z8673","J984","F10931","Z472","S62521K","E118","M4726","R7401","R900","F10129","Z029","D759","S199XXA","R109","S8991XA","Z4789","M799","X58XXXD","Z967","R2231","R9431","L729","G4089","R208","I499","J029","R0981","L02511","G40804","R269","Z0189","R296"],"date":["2025-12-20","2024-02-29","2025-12-23","2025-12-24","2023-11-16","2025-12-22","2025-12-20","2023-11-13","2024-02-25","2024-01-06","2023-11-11","2025-12-20","2025-05-08","2025-02-20","2025-12-25","2025-12-22","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-07-22","2025-12-20","2025-12-21","2025-12-25","2025-12-25","2025-12-25","2025-12-25","2025-12-25","2025-12-25","2025-12-25","2025-12-22","2025-12-22","2025-12-24","2023-11-19","2024-01-24","2024-01-24","2024-01-24","2024-04-04","2024-01-26","2024-01-26","2025-12-22","2024-01-06","2025-12-22","2024-02-23","2024-01-06","2025-02-20","2024-02-08","2024-02-08","2024-02-08","2024-02-08","2022-08-28","2023-11-09","2024-03-29","2024-02-08","2025-06-23","2024-08-28","2025-05-08","2025-06-26","2025-08-14","2025-11-06","2026-01-14","2025-12-23","2024-02-29","2024-01-06","2024-02-06","2024-05-02","2023-11-16","2023-11-11","2025-12-24","2023-11-11","2024-01-24","2024-01-24","2024-01-25","2024-01-24","2024-02-06","2024-02-29","2024-08-28","2023-11-16","2025-02-20","2025-02-20","2025-02-20","2025-05-09","2023-11-16","2024-04-04","2024-05-08","2025-06-11","2026-01-23","2024-01-06","2024-01-06","2024-05-04","2025-05-29","2025-12-22","2025-12-23","2026-01-02","2025-12-23","2024-02-23","2024-02-23","2024-04-04","2024-04-04","2025-07-22","2024-07-29","2025-07-29","2025-12-22","2024-05-02","2025-05-09","2025-02-13","2025-02-13","2025-07-22","2025-12-23","2025-12-23","2024-07-29","2025-12-23"],"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":[["","","FYCOMPA","","","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":[]}},{"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":""}]}]}