{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VANCE HOLLIDAY JR","gend":0,"currentgend":"","add":"1575 N PENNSYLVANIA ST APT 1015","city":"DENVER","state":"CO","zip":"80203","dob":"1960-12-06","age":"","mstatus":"","insh":2000236276,"cliId":"","pno":"7204017830","cno":"7204017830","email":"","ename":"","eno":"","pphy":"TREFILEK, BENJAMIN T","ppno":3034366000,"pcpadd":"DENVER HEALTH ORTHOPEDICS,777 BANNOCK ST","pcpcity":"DENVER","pcpstate":"CO","pcpzip":"80217","pcpcounty":"","pcpid":"","pcpname":"EASTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1575 N PENNSYLVANIA ST APT 1015","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80203","pcpfaxno":3034366572,"pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2000236276","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R609","M1711","M1712","R531","Z743","I4510","Z0189","I493","Z96652","I4720","I5030","I2720","I2510","Z48812","I110","Z515","F321","I872","R197","K4030","M25562","M25551","G8929","Z95810","Z951","I50812","M160","M1611","R001","R600","R1031","Z9981","I5022","Z471","H04123","M19011","I25118","K922","I10","Z01818","M159","I4729","R079","Z96651","Z0389","M7989","R32","I445","Z4502","Z7689","K4090","Z96641","Z029","B349","D500","G4719","Z131","K625","L602","D696","K5900","M109","I509","K4020","R000","I25810","R2689","H2513","H5213","H52222","I3481","I358","I071","Z95818","I452","F5104","Z7722","M25552","I50810","E8770","Z950","M25811","M479","Z96612","M150","Z79891","M79661","M79662","Z4789","F32A","I87309","E669","Z6841","Z96653","M25511","R634","I081"],"date":["2025-08-04","2025-08-04","2023-12-12","2025-07-21","2023-12-11","2025-10-01","2023-12-09","2024-06-28","2024-04-08","2025-07-25","2024-02-20","2023-12-11","2025-01-17","2024-02-20","2024-02-20","2026-01-13","2025-08-13","2025-08-13","2025-07-23","2025-04-09","2025-06-18","2026-01-13","2025-06-18","2026-01-06","2025-07-25","2025-07-25","2025-08-25","2025-12-22","2024-02-13","2025-12-31","2023-09-08","2023-08-30","2026-01-08","2026-01-13","2024-01-31","2024-08-13","2025-09-10","2025-06-19","2024-12-08","2025-11-24","2026-01-25","2024-06-28","2025-06-25","2024-04-11","2023-12-09","2023-12-24","2025-10-17","2025-10-01","2025-06-30","2024-08-21","2025-10-30","2026-01-29","2026-01-29","2023-08-07","2024-07-26","2024-02-05","2024-09-26","2025-03-18","2025-10-21","2025-09-11","2023-04-30","2024-01-24","2025-04-18","2025-10-09","2023-12-09","2024-06-28","2024-04-08","2024-01-31","2024-01-31","2024-01-31","2025-10-27","2025-10-27","2025-10-27","2025-10-27","2023-04-30","2024-03-13","2024-03-13","2023-09-19","2025-04-18","2025-04-18","2025-06-25","2025-09-12","2025-09-12","2025-09-12","2025-11-18","2025-12-16","2023-05-01","2023-05-01","2024-04-11","2024-07-24","2024-10-16","2024-10-16","2024-10-16","2025-08-25","2024-08-13","2025-05-07","2023-12-09"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","MORPHINE SULFATE ER","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","FENTANYL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","BETAMETHASONE VALERATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","BUMETANIDE","","","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":""}]}]}