{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARYON MOORE","gend":1,"currentgend":"","add":"5185 MARTIN LUTHER KING BLVD","city":"DENVER","state":"CO","zip":"80207","dob":"1947-04-09","age":"","mstatus":"","insh":7000009052,"cliId":"","pno":"7204298920","cno":"7204298920","email":"","ename":"","eno":"","pphy":"DIETZ, DEIDRE A","ppno":"","pcpadd":"1226 W ASH ST,STE B","pcpcity":"WINDSOR","pcpstate":"CO","pcpzip":"80550","pcpcounty":"","pcpid":"","pcpname":"PARK HILL FAM MED MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5185 MARTIN LUTHER KING BLVD","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80207","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000009052","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M546","S32010A","W19XXXA","M5489","Z743","M549","Z9989","S32018A","R0602","R079","R531","R509","R0902","M5450","L988","Z4789","M5386","S0592XA","S32019A","S33140A","M533","M542","R911","R197","H40003","M25432","M160","M25512","M25522","M79602","M25532","M25551","R42","J9811","M11261","M1610","R2241","E1165","M353","F0280","I10","K219","I6789","R410","J9601","J441","I129","N1831","I739","Z720","I2510","I70213","I7092","Z48812","F01518","E236","R5383","M8949","M064","K449","M25511","M62838","R55","G4762","M79605","J45901","E118","R0789","R000","R61","D72825","J101","J111","J4489","D649","S22000A","D62","I110","J189","E1129","E876","H11222","S32011D","N179","R630","R471","R1084","H524","M19072","M19071","M11242","M11241","M19011","M19012","M11262","R110","R059","Z1231","R9431","E119","M9983","G8929","I959","R739","R0600","E8720","H5213","Z961","H04123","J45998","F17200","I70212","Z01810","E785","N3289","K769","N2889","R109","K921","F0390","Z7902","K263","S32010G","E113212","E113291","R270","Z8673","R260","R4182","I70203","M79641","R519","R051","J122","I6523","R634","I771","Z122","M1189","I498","M4856XD","M4317","M4807","M48061","M5127","M5126","M5137","M5136","H47393","I663","T50905A","J984","I252","E1142","S32010D","I080","R030","R7989","J449","Y040XXA","K254","R918","R590","R569","R1010","I770","M159","M810","Z7952","M47812","Z20822","E860","I745","I2129","T148XXA","R609","Z98890","T82848A","R52","R700","M2550","R7982","I4891","R413","R2689","M792","I342","I509","S0990XA","Z7901","Z043","I5030","I3481","I340","I700","M1180","M1120","M25531","I5A","N898","R1031","E88810","I639","Z760","Z79899","Z8739","D72824","D72820","E861","W1830XA","M25521","R58","H538","R278","M5442","Z87891","J439","Z452","M5440","R932","R195","K259","M11862","M11812","M11832","M11861"],"date":["2024-08-11","2024-10-17","2024-10-17","2024-10-16","2026-01-26","2024-08-17","2024-08-17","2024-08-18","2025-02-26","2025-03-04","2025-03-16","2024-08-29","2024-08-29","2024-08-29","2024-10-17","2024-10-16","2024-11-26","2024-10-22","2024-10-16","2024-11-26","2024-11-26","2024-12-26","2024-12-22","2024-12-20","2025-02-11","2025-03-04","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-04","2025-03-16","2026-01-26","2025-03-16","2025-03-17","2025-03-17","2025-03-17","2025-03-11","2025-03-11","2025-03-11","2025-03-11","2025-03-11","2025-06-12","2025-06-12","2023-09-17","2025-07-03","2023-09-14","2024-06-09","2024-10-16","2024-02-06","2024-01-19","2024-01-18","2024-01-18","2024-01-19","2024-01-19","2024-10-10","2022-08-08","2022-09-14","2022-09-02","2024-08-18","2025-07-24","2023-03-13","2024-08-02","2023-06-23","2024-03-05","2024-06-06","2025-11-25","2025-03-04","2025-03-03","2024-04-23","2024-05-09","2024-06-15","2024-06-11","2024-06-11","2024-10-09","2024-08-14","2024-08-18","2024-08-25","2024-08-26","2024-12-11","2024-12-19","2024-11-10","2024-11-26","2024-12-19","2025-04-10","2025-06-12","2024-08-02","2022-05-18","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2023-08-03","2025-03-13","2025-02-14","2023-06-01","2025-07-03","2025-09-24","2023-09-25","2023-11-22","2024-12-20","2023-11-20","2024-06-09","2024-06-09","2022-05-18","2022-05-18","2022-05-18","2023-09-10","2023-09-26","2024-02-06","2024-06-09","2024-06-07","2024-08-02","2024-08-02","2024-08-02","2024-08-25","2024-08-18","2025-03-13","2024-08-18","2024-08-18","2024-10-16","2024-11-21","2024-11-21","2025-06-12","2025-06-12","2025-06-13","2025-06-13","2024-01-18","2022-04-26","2023-05-01","2022-11-21","2023-09-11","2024-12-27","2024-07-16","2025-01-02","2023-11-15","2025-03-03","2024-06-13","2024-08-29","2024-08-29","2024-08-29","2024-08-29","2024-08-29","2024-08-29","2024-08-29","2024-08-29","2024-11-21","2024-12-22","2025-02-26","2025-07-03","2026-01-27","2023-06-01","2024-08-20","2023-11-21","2023-11-22","2025-03-03","2024-06-14","2024-08-11","2024-08-18","2025-02-15","2025-02-15","2024-06-18","2024-08-09","2024-12-17","2024-08-21","2022-09-02","2024-08-18","2022-09-02","2023-04-28","2023-04-28","2024-01-17","2024-02-11","2024-08-11","2024-08-29","2024-09-01","2024-10-16","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-13","2023-05-01","2024-06-18","2024-06-18","2024-08-26","2024-08-25","2024-10-16","2024-10-16","2024-10-16","2025-03-05","2025-03-05","2025-03-05","2025-03-05","2025-03-06","2025-03-06","2025-03-06","2025-03-06","2025-03-04","2025-03-04","2025-03-18","2025-06-12","2023-07-20","2022-11-04","2022-11-04","2024-04-29","2024-04-29","2024-05-18","2024-08-11","2024-10-16","2024-11-10","2024-10-22","2025-06-12","2023-09-25","2023-11-15","2023-11-15","2023-11-21","2024-08-21","2024-08-21","2024-08-18","2024-08-17","2025-03-04","2025-03-04","2025-03-04","2025-03-04"],"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":[["","","GABAPENTIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","LANSOPRAZOLE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","PREDNISONE","","","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":""}]}]}