{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DIANE JESSER","gend":1,"currentgend":"","add":"2759 S ACOMA ST","city":"ENGLEWOOD","state":"CO","zip":"80110","dob":"1956-10-19","age":"","mstatus":"","insh":7000008749,"cliId":"","pno":"3037610285","cno":"3037610285","email":"","ename":"","eno":"","pphy":"ZHENG, JULIA J","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"DH PAV G ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2759 S ACOMA ST","madd2":"","madd3":"","mcity":"ENGLEWOOD","mstate":"CO","mzip":"80110","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000008749","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F1120","J8410","J441","J449","R0902","J13","R410","Z743","I10","A419","J9601","R4182","R0600","G9341","G928","J690","E876","R2681","F1123","R079","I739","L84","G629","M216X1","M216X2","G5793","L603","G40909","N6459","C44329","R569","N6313","N6315","R921","N6011","J9621","J189","R7989","K8020","N200","R2243","J9811","R0602","J90","Z23","R7881","H5709","J811","L905","Z85828","M79671","Z1231","N6310","R92323","Z20822","R6520","R778","R9401","Z720"],"date":["2026-01-28","2024-11-19","2022-01-26","2025-03-13","2022-03-02","2022-03-02","2025-02-24","2025-03-12","2025-08-22","2025-02-26","2025-02-26","2025-02-25","2025-03-12","2025-02-26","2025-02-26","2025-03-04","2025-03-13","2025-03-12","2025-03-12","2025-03-12","2025-10-21","2026-01-29","2025-10-21","2026-01-29","2026-01-29","2026-01-29","2026-01-29","2025-03-13","2025-05-09","2025-07-24","2025-03-12","2025-05-09","2025-05-09","2025-05-09","2025-05-12","2022-01-26","2022-01-26","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2025-02-27","2025-02-27","2025-02-27","2022-11-09","2022-01-26","2022-01-20","2025-02-27","2025-07-27","2025-07-27","2023-03-03","2025-05-07","2025-05-07","2025-05-07","2022-01-13","2022-01-13","2025-02-25","2025-02-26","2025-06-09"],"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":[["","","CEFDINIR","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","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":""}]}]}