{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HENRY SPEIGHT","gend":0,"currentgend":"","add":"4681 W SHORT PL","city":"DENVER","state":"CO","zip":"80204","dob":"1956-11-13","age":"","mstatus":"","insh":7000012395,"cliId":"","pno":"3034356175","cno":"3034356175","email":"","ename":"","eno":"","pphy":"CREIGHTON, SUSAN L","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","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":"4681 W SHORT PL","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80204","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7000012395","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E871","R0789","F1010","E222","R634","K529","K635","M4712","J9601","R197","Q2730","G9589","Z4789","I7789","M25562","R61","G928","I959","G629","R079","I2510","M542","E8342","F1020","G621","F1521","F32A","F419","Z029","I25110","Z955","M4322","M4802","M6281","R262","M4716","R918","R933","R1310","K2970","K3189","R9431","R0602","Z743","M549","M7989","Z8679","M25552","Z7409","I739","M79604","M79605","R001","I252","I10","R4182","N400","R109","A044","R300","D123","D122","D124","D120","D128","Z1211","K921","D509","J810","I770","M79644","M5450","F331","F10121","R269","R410","R519","W19XXXA","Q2731","R030","R110","R195","I444","R55","M19012","Z98890","M11262","J441","K5900","R531","R338","J432","I499","F1021","J449","F17210","Z741","Z5982","F1091","I868","R222","J90","N312","R3914","R3916","T85113A","Z9682","R931","R1084","R100","K766","E785","S32040A","M25441","R627","I351","M4316","S22050A","S22060A","S22070A","S22080A","R0600","M20001"],"date":["2025-05-20","2024-08-12","2024-07-24","2024-03-28","2024-07-10","2024-05-06","2024-06-05","2024-09-17","2025-01-20","2025-11-10","2025-03-04","2026-01-16","2025-08-01","2025-12-11","2025-12-18","2024-02-07","2024-08-12","2023-02-22","2023-02-22","2024-08-12","2024-03-29","2023-03-11","2023-03-11","2023-08-17","2023-02-22","2023-02-22","2023-03-10","2023-03-10","2023-05-08","2023-08-18","2023-08-18","2023-07-25","2023-07-25","2023-07-25","2023-07-25","2023-07-25","2024-03-28","2024-04-23","2024-04-24","2024-04-24","2024-06-06","2024-08-15","2024-08-12","2024-08-12","2024-08-12","2025-08-05","2024-09-26","2025-12-11","2025-08-14","2023-05-18","2023-05-18","2025-12-03","2024-03-29","2023-08-20","2024-04-30","2024-08-20","2023-08-27","2024-03-28","2024-04-30","2024-04-23","2024-06-07","2024-06-07","2024-06-07","2024-06-07","2024-06-07","2024-06-06","2024-06-06","2024-06-06","2024-08-12","2025-03-04","2025-08-05","2024-08-30","2025-09-12","2023-08-26","2024-03-28","2024-08-13","2024-08-13","2025-12-11","2025-12-11","2023-09-13","2023-06-14","2023-06-14","2024-03-28","2023-08-26","2025-12-11","2025-12-11","2025-12-11","2023-02-20","2024-03-30","2024-03-30","2024-03-30","2024-03-29","2024-04-23","2024-04-24","2024-04-24","2024-04-30","2024-04-30","2024-04-30","2024-06-05","2024-08-30","2023-09-22","2023-08-25","2023-11-17","2023-11-17","2023-11-17","2023-11-17","2023-11-17","2024-03-28","2024-03-28","2024-03-28","2024-07-10","2023-08-18","2025-02-20","2025-08-01","2024-04-23","2024-08-14","2024-09-05","2024-09-05","2024-09-05","2024-09-05","2024-09-05","2023-02-20","2025-02-19"],"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":[["","","LEVOFLOXACIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","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":""}]}]}