{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAROLYN WHITE","gend":1,"currentgend":"","add":"2797 W 13TH AVE","city":"DENVER","state":"CO","zip":"80204","dob":"1953-09-18","age":"","mstatus":"","insh":7000010174,"cliId":"","pno":"3033773003","cno":"3033773003","email":"","ename":"","eno":"","pphy":"HANRATTY, REBECCA L","ppno":3032210370,"pcpadd":"8200 E BELLEVIEW AVE,STE 418C","pcpcity":"GREENWOOD VILLAGE","pcpstate":"CO","pcpzip":"80111","pcpcounty":"","pcpid":"","pcpname":"EASTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"UNIT 313","add3":"","madd1":"2797 W 13TH AVE","madd2":"UNIT 313","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80204","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000010174","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R627","J205","E039","F332","R079","R0789","G894","R109","J690","A419","L600","Z23","S065XAA","M4802","R4189","R1084","R110","G8929","R279","Z743","R531","R112","R52","H524","H52222","Z98890","H50331","H04123","R918","J90","Z20822","R0902","E876","J189","J188","K838","D1803","K8689","I10","K219","M62838","S90811D","D649","M546","R0602","R160","K760","N3289","N3000","F419","F03918","R6251","B338","Z0389","R42","R519","R262","R100","J439","R590","J9601","E8720","K920","L89616","L89626","L858","Z7409","R6889","M79644","S22080A","M5450","H50111","Z48810","M7910","M8000XD","K5900","L89610","M79671","L89153","S0180XA","Z712","R0989","R232","M79651","M5442","R059","M79605","M7989","M79672","G629","K5901","F418","Z029","F918","F411","F32A","R509","R1110","R197","R1314","F0634","E871","E46","Z01818","B370","D696","D72829","S92512A","H25813","M79604","M2550","R5381","Z1231","N6489","S92912A","W1830XA","B351","L853","M80072D","N3090","S90811A","Z79899","G2401","F688","M6281","R030","S3991XA","Z9981","W19XXXA","E8330","L089","L03116","Z9181","H5010","M79675","X58XXXA","L603","S92532A","S92511D","R600","Z7189","D751","F17200","I70203","L84","Z7902","S92512D","I6200","M4854XA","R32","I499","H44811","R1011","K6389","G9389","L99","Z0000","R001","R9431","C109","L8993","T17300A","R2689","M5416","R072","F17210","M25851","R000","I493","I4519","R0781","R1032","N281","K6289","L989","R1031","K449","N2889"],"date":["2026-01-27","2025-01-16","2026-01-13","2025-12-19","2025-12-31","2025-10-28","2026-01-27","2025-12-31","2026-01-19","2026-01-02","2022-01-31","2024-10-02","2023-08-07","2023-12-01","2024-01-31","2024-12-26","2024-07-20","2024-12-27","2025-06-21","2026-01-10","2025-12-31","2024-12-31","2025-10-28","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2024-07-22","2025-12-31","2022-10-27","2024-04-15","2026-01-27","2026-01-08","2023-01-15","2025-12-31","2025-12-31","2023-05-01","2026-01-27","2024-12-31","2023-10-06","2023-10-05","2023-09-27","2024-04-14","2025-06-19","2024-12-22","2024-12-22","2024-12-22","2024-12-31","2025-01-03","2025-01-29","2025-01-11","2025-01-14","2025-04-23","2025-06-19","2025-06-21","2025-10-28","2025-12-31","2025-12-31","2025-12-31","2026-01-02","2026-01-02","2026-01-02","2026-01-31","2026-01-29","2026-01-29","2026-01-29","2026-01-10","2022-01-05","2022-02-01","2022-04-06","2022-05-20","2022-05-27","2022-06-10","2023-02-28","2023-01-14","2023-03-17","2023-03-01","2023-06-09","2023-07-24","2023-08-16","2023-10-01","2024-06-26","2024-07-13","2025-10-29","2026-01-26","2024-12-10","2022-06-27","2023-03-01","2023-10-27","2023-10-06","2024-12-26","2025-04-17","2024-12-27","2025-01-29","2025-01-29","2026-01-02","2026-01-02","2026-01-20","2026-01-27","2026-01-27","2026-01-27","2026-01-27","2022-04-26","2026-01-13","2026-01-13","2026-01-16","2022-04-13","2022-04-26","2024-12-10","2022-12-14","2023-11-03","2022-01-12","2022-03-09","2022-04-13","2022-04-13","2023-10-16","2022-09-07","2022-09-07","2022-10-27","2023-09-28","2024-12-17","2023-10-27","2024-07-13","2024-07-13","2024-12-18","2025-10-28","2025-10-28","2025-10-28","2026-01-12","2023-05-03","2022-02-16","2023-09-08","2022-07-13","2022-02-01","2022-02-01","2023-10-16","2022-04-13","2022-06-27","2022-06-28","2023-10-27","2023-10-27","2023-10-12","2023-10-16","2023-10-16","2025-06-19","2022-06-28","2023-08-07","2024-04-14","2025-07-02","2025-12-31","2025-04-08","2022-10-26","2024-04-14","2024-04-14","2024-12-10","2025-01-07","2025-06-20","2025-06-20","2023-06-09","2023-06-09","2026-01-08","2023-09-26","2024-01-23","2024-07-15","2023-01-15","2024-07-13","2025-06-19","2025-06-19","2025-06-19","2025-10-28","2025-10-28","2025-12-31","2025-12-31","2023-08-31","2022-10-26","2024-12-18","2024-12-18"],"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":[["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","ONDANSETRON ODT","","","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":""}]}]}