{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FREDERICK KAPLAN","gend":0,"currentgend":"","add":"1040 OSAGE ST","city":"DENVER","state":"CO","zip":"80204","dob":"1947-05-06","age":"","mstatus":"","insh":7000010876,"cliId":"","pno":"3037264878","cno":"3037264878","email":"","ename":"","eno":"","pphy":"LUBLINE, ZACHARY L","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"EASTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 706","add3":"","madd1":"1040 OSAGE ST","madd2":"APT 706","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80204","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000010876","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1711","I517","I519","H353231","R0902","H2512","I10","Z48810","Z961","H2511","H18513","H353290","H04123","H5015","H532","I77810","E871","J9601","J101","I4891","R052","I2510","I480","Z48812","I25118","I110","R7303","J9621","R0609","D509","D469","H2513","H35361","H50111","H527","D693","E669","K219","F418","Z96651","M25561","Z1159","Z01818","F4321","H539","H353221","F419","H353291","I491","R9431","R0602","R079","Z743","R42","I2584","I2583","I2541","E8770","R7989","G4700","K529","Z471","E222","G8929","E6601","Z6841","I214","M5450","Z460","R0689","I493","I440","R918","F339","H353230","R059","Z1211","Z043","W19XXXA","I4710","I4720","J069","R051","H3530","E66813","R600","Z8674"],"date":["2023-08-28","2025-01-23","2023-06-20","2026-01-07","2025-05-02","2024-02-07","2025-10-13","2024-05-08","2024-07-17","2024-03-28","2024-02-23","2024-07-17","2024-07-17","2024-11-20","2024-11-04","2025-01-23","2025-01-25","2025-01-24","2025-02-04","2025-10-13","2025-02-04","2025-08-01","2025-10-13","2025-07-11","2025-10-13","2025-07-11","2025-08-01","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2023-11-01","2023-11-01","2023-11-01","2023-11-01","2023-08-16","2023-08-16","2023-08-16","2023-08-16","2023-09-13","2023-07-26","2023-04-28","2023-11-01","2023-08-15","2023-10-13","2026-01-07","2024-12-10","2024-10-30","2026-01-17","2025-01-23","2026-01-16","2025-01-22","2026-01-16","2024-02-13","2025-07-10","2025-07-10","2025-07-10","2026-01-19","2026-01-16","2022-04-22","2022-06-03","2023-10-06","2025-01-25","2023-07-26","2023-07-26","2023-07-26","2023-07-26","2023-07-26","2024-08-12","2025-01-25","2025-07-12","2026-01-17","2026-01-16","2023-06-28","2024-12-13","2025-01-22","2022-03-07","2023-06-19","2023-06-19","2025-06-05","2025-06-05","2022-12-15","2024-12-26","2024-07-17","2025-10-13","2026-01-16","2023-06-20"],"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":[["","","ELIQUIS","","","Select","Select",""],["","","MUPIROCIN","","","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":""}]}]}