{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RUDOLPH GOMEZ","gend":0,"currentgend":"","add":"1590 YATES ST APT 510","city":"DENVER","state":"CO","zip":"80204","dob":"1937-05-27","age":"","mstatus":"","insh":7000006766,"cliId":"","pno":"7202805891","cno":"7202805891","email":"","ename":"","eno":"","pphy":"RECEIVING PRIMARY CARE","ppno":4062374116,"pcpadd":"1233 N 30TH ST,","pcpcity":"BILLINGS","pcpstate":"MT","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"SLOANS LAKE PRIM CARE MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1590 YATES ST APT 510","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80204","pcpfaxno":4062374125,"pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000006766","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H40003","H40053","Z79899","H52203","M7989","S92352A","V0310XA","H47393","U071","J9601","E876","I480","S0990XA","N1330","R9389","R42","K8020","J90","W19XXXA","K5730","I2510","I5030","I082","I77810","I4819","R339","N179","D72829","N139","R319","R2689","Z743","I4891","I444","I252","I420","I10","E785","Z043","R410","R609","R4182","G4733","R918","S50912A","S50911A","S50901A","R54","I110","I5040","I5A","I493","I5021","M25551","G9349","E8770","I2720","I255","E119","I5020","I2584","Z7902","I509","I5022","E871","E43","E861","S60911A","S50311A","S50312A","S50812A","M6281","Z5181","F03A0","N401","H401190","E039","K828","N400","S31000A","D509","S50911D","S30810A","S41101A","S60912A","N138","E46","S50811A","S60812A","E1142","B351","S51801D","S31000D","F02A0","S60921A","S50912D","R5382","E8351","E559","D500","Z7189","R531","E089","H52223","E113393","H8111","D649","M12811","D174","R0602","R4189","I130","Z23","R300","S40812A","S30810D","S40811D","S60512A","S51801A","E113293","Z961","R310","S60947D","S51002A","S91104A","S90934A","S5001XA","E786","D508","H4010X0","J9811","J984","I700","J811","I771","X58XXXA","S50311D","Z960","E1165","F0390","S60947A","E11628","S90934D","N320","S50901D","I4820","G301","F02B0","N178","S60912D","H524","H11133","H02883","H02886","H11152","R441","R222","S51002D","E038","I083","I3139","Z955","S60911D","S50312D","E1169","S60512D","S60511A","R296","R911","N3289","N134","R443","M8588","S5001XD","G319","R9082","R1111","N189","Z0189","S60921D","R0600","R0609","N10","S50811D"],"date":["2022-12-09","2022-05-18","2026-01-15","2022-04-06","2025-05-12","2022-08-12","2022-08-12","2022-11-14","2025-01-08","2025-05-04","2025-06-13","2025-12-11","2025-01-15","2025-01-25","2025-06-03","2025-01-15","2025-06-03","2025-12-03","2025-02-03","2025-01-15","2025-11-07","2025-05-31","2025-01-16","2025-01-16","2025-01-16","2025-04-17","2025-05-22","2025-01-25","2026-01-22","2025-07-25","2025-05-22","2025-07-16","2025-11-17","2025-05-17","2025-05-17","2025-02-13","2025-05-31","2026-01-14","2025-02-03","2025-02-03","2025-05-09","2025-03-31","2025-11-17","2025-04-10","2026-01-20","2025-10-21","2025-04-29","2026-01-27","2026-01-14","2025-05-12","2025-03-24","2025-05-17","2025-07-13","2025-05-12","2025-05-15","2025-05-22","2025-05-16","2025-05-22","2026-01-14","2026-01-14","2025-05-16","2025-05-16","2025-10-21","2025-11-07","2026-01-14","2025-07-14","2025-07-14","2025-08-05","2025-07-01","2025-08-05","2025-08-26","2025-07-24","2025-08-06","2025-11-18","2026-01-22","2025-08-22","2026-01-14","2025-11-14","2026-01-14","2025-08-05","2025-12-11","2025-10-28","2025-09-09","2025-09-09","2025-09-30","2026-01-22","2025-09-10","2026-01-27","2025-09-23","2025-11-25","2025-11-25","2025-08-29","2025-08-29","2026-01-14","2025-12-02","2026-01-27","2025-11-19","2025-12-02","2025-12-02","2025-12-08","2025-05-31","2025-07-16","2025-08-22","2022-01-10","2022-05-11","2023-03-17","2026-01-14","2025-01-10","2025-02-03","2025-04-07","2025-06-13","2025-05-09","2025-10-16","2025-07-23","2025-08-26","2025-09-16","2025-09-16","2025-10-28","2025-07-29","2022-12-09","2022-05-18","2025-01-26","2025-02-11","2025-02-25","2025-02-11","2025-02-18","2025-03-25","2025-02-19","2025-02-19","2025-05-29","2025-05-09","2025-05-09","2025-05-09","2025-05-01","2025-05-15","2025-05-12","2025-07-08","2025-10-20","2025-05-04","2025-04-25","2025-02-04","2025-01-28","2025-02-25","2025-04-17","2025-05-06","2025-05-22","2025-06-13","2025-06-13","2025-07-11","2025-10-07","2022-01-10","2022-06-06","2022-06-06","2022-06-06","2022-06-06","2025-02-03","2025-02-03","2025-03-24","2025-03-04","2025-05-12","2025-05-12","2025-07-17","2025-08-12","2025-08-12","2025-11-07","2025-11-11","2025-11-11","2025-11-17","2025-04-29","2025-01-16","2025-01-16","2025-02-03","2025-02-03","2025-04-01","2025-07-13","2025-07-13","2025-04-04","2025-07-03","2025-01-16","2025-12-09","2025-01-15","2025-01-15","2025-01-15","2025-12-02"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","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":""}]}]}