{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VICTOR GONZALEZ","gend":0,"currentgend":"","add":"5050 ALCOTT ST","city":"DENVER","state":"CO","zip":"80221","dob":"1957-09-13","age":"","mstatus":"","insh":7000006401,"cliId":"","pno":"7206269017","cno":"7206269017","email":"","ename":"","eno":"","pphy":"ZAK, REBEKKA K","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"LA CASA FAM MED MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5050 ALCOTT ST","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80221","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000006401","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C9210","C9201","Z452","C9212","C9101","Z9481","E11319","J90","I6202","C9100","I081","I313","R931","R7401","Z79899","N281","R162","I6200","K7200","K7682","E8720","D65","E806","R748","K769","Z4682","E8352","E8770","E870","N179","R601","E790","D696","D61818","D849","J189","E119","I10","K7290","S065XAA","R509","D689","Z7984","E118","J811","E1165","T380X5A","R4182","R579","K7689","J9601","D649","D539","Z52001","Z9484","R197","R161","C9290","R112","Z743","R21","D89813","Z7682","C9211","R0789","N289","Z0289","E113593","M25512","H540X55","G893","Z5111","T865","R0902","Z7969","H2589","H4053X3","C9291","J9811","R9389","R600","K921","Z794","K5900","K1230","R059","R0989","R918","I2510","E559","Z2989","E1139","E113493","Z7185","R945","K1379","R7402","Z1211","K08409","Y848","R2243","N2889","A419","M79662","M79661","Z9911","D61810","D709","R7881","B9689","Z95828","Z961","D72810","R932","D72829","I517","R079","R52","R9089","J9600","G9340","R17","K529","R5081","B957","H2522","H4050X3","R1084","R34","R836","R140","Z758","R911","K828","K760","R9431","E041","I3139","H40053","H04123","N401","R350","H540X45","H16223","T451X5D","I445","R6520","E876","M65222","M25811","R0689","I6203","R160","R6521","R571","N12","Z09"],"date":["2026-01-30","2025-08-01","2025-09-03","2025-10-01","2025-10-31","2026-01-30","2025-12-29","2025-06-24","2025-01-03","2025-08-18","2022-01-06","2022-01-06","2022-01-06","2024-12-26","2024-12-09","2025-01-11","2025-01-07","2025-06-24","2025-01-24","2025-01-08","2025-06-04","2025-02-22","2025-01-07","2025-01-04","2025-01-07","2025-01-14","2025-01-14","2025-01-21","2025-01-24","2025-02-22","2025-01-15","2025-01-13","2025-06-20","2025-08-07","2025-12-30","2025-02-22","2025-10-08","2025-08-29","2025-02-22","2025-02-22","2025-05-26","2025-03-31","2025-04-03","2025-06-07","2025-01-21","2025-04-02","2025-04-03","2025-01-13","2025-01-08","2025-01-07","2025-01-14","2025-06-20","2025-03-05","2025-05-22","2025-06-09","2025-06-03","2025-06-23","2025-06-23","2025-06-24","2025-06-23","2025-09-10","2026-01-09","2025-10-01","2025-08-01","2024-12-26","2022-01-27","2023-06-08","2025-11-04","2024-08-20","2025-08-29","2024-12-25","2025-05-22","2025-06-23","2025-01-15","2023-10-20","2025-11-04","2025-11-04","2025-01-05","2025-06-24","2025-05-26","2025-01-29","2025-01-19","2025-04-03","2025-05-23","2025-06-01","2025-06-01","2025-06-01","2025-08-19","2025-08-19","2025-08-29","2025-12-16","2026-01-09","2025-08-29","2025-10-31","2025-12-30","2025-12-30","2025-01-03","2022-10-07","2022-10-20","2025-03-31","2025-01-10","2025-01-03","2025-01-08","2025-01-26","2025-01-26","2025-01-14","2025-06-09","2025-06-03","2025-06-09","2025-06-09","2025-08-22","2025-11-04","2025-06-20","2022-01-27","2024-12-25","2025-01-08","2025-06-23","2025-01-07","2025-01-12","2025-01-12","2025-01-14","2025-02-22","2025-05-26","2025-05-28","2025-06-09","2022-08-12","2022-08-12","2025-01-25","2025-01-12","2025-04-28","2025-01-25","2025-02-22","2025-06-24","2025-01-08","2025-01-08","2025-06-03","2025-06-24","2025-06-24","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2025-12-16","2025-09-11","2023-05-22","2025-01-03","2025-01-07","2025-06-08","2024-08-07","2024-08-07","2022-01-05","2025-01-07","2025-01-03","2025-01-08","2025-01-08","2025-01-09","2022-01-19"],"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":[["","","LABETALOL HCL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","EYSUVIS","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ACYCLOVIR","","","Select","Select",""],["","","DAPSONE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","MYCOPHENOLATE MOFETIL","","","Select","Select",""],["","","DORZOLAMIDE-TIMOLOL","","","Select","Select",""],["","","BRIMONIDINE TARTRATE","","","Select","Select",""],["","","ATROPINE SULFATE","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CRESEMBA","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","PAXLOVID","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":[]}},{"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":""}]}]}