{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CARLOS MONTOYA","gend":0,"currentgend":"","add":"2626 OSCEOLA ST","city":"DENVER","state":"CO","zip":"80211","dob":"1949-01-03","age":"","mstatus":"","insh":101398437,"cliId":"","pno":"7203175861","cno":"7203175861","email":"","ename":"","eno":"","pphy":"ELWELL, DAVID W","ppno":"","pcpadd":"SWEDISH PORTER EKG,3464 S WILLOW STREET STE 101","pcpcity":"DENVER","pcpstate":"CO","pcpzip":"80231","pcpcounty":"","pcpid":"","pcpname":"DH PAV G ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 1415","add3":"","madd1":"2626 OSCEOLA ST","madd2":"APT 1415","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80211","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"101398437","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E662","J9610","J449","I5020","H524","H52223","L03116","A419","R6520","L03119","N179","R001","J9611","R531","I890","R5381","R269","L0390","I498","R600","R410","L870","J9621","I440","I2510","I5030","F419","I10","G4700","R079","N390","T8130XA","L89159","S21102A","S31809A","Z950","I495","I214","R7989","I110","I5033","I2584","I2720","I5032","I428","R42","I517","I5040","I358","I77810","R000","I4891","I493","I459","I4510","I4729","I351","Z515","I4892","I5023","I5043","D509","R5383","I252","D62","R578","K922","R7881","B952","D500","I700","R918","Z0189","G9340","G9341","L089","R760","Z743","R195","Z7689","A4189","A4181","I130","R296","G4733","J9612","R591","R634","Z8719","R609","N189","E8770","I5031","I059","R451","I447","I4720","I4719","I3481","I081","M19012","M25812","R9431","K31819","K9189","I959","R1311","M6281","N1831","I509","I6789","B9689","N400","R0902","E876","R6884","H40003","R1031","I729","T8454XA","I724","D649","M150","R0602","R4182","K8020","I491","I454","R55","H5213","H25813","H52203","H04123","R7303","I350","I161","R0600","Z95818","Z9911","R0989","J90","G4731","R008","Z136","I7121","Z4682","T8454XS","E785","Z45018","G9349","T82897A","K439","J9809","I4901","I3139","N401","D696","K921","K635","K5730","K644","J984","M7989","M13869","I5022","I288","I219","N3090","I441","K551","R0689","Z9989","J9601","I129","N1830","N281","R9389","H2513","Z9229","H5704","Z1211","R937","I6523","I6503","R319","K449","R931","R197","Z0389","E871","E538"],"date":["2023-09-03","2023-09-03","2026-01-07","2025-08-31","2025-12-23","2023-06-01","2025-01-30","2025-09-10","2025-01-30","2025-04-08","2025-12-12","2025-12-12","2025-09-23","2025-09-09","2025-04-07","2026-01-07","2025-04-06","2025-04-06","2025-03-27","2025-07-09","2025-07-20","2025-02-11","2025-04-23","2025-04-09","2025-07-25","2025-08-29","2025-04-09","2025-08-08","2025-04-02","2025-12-10","2025-12-12","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-12-11","2025-07-12","2025-09-25","2025-06-01","2025-11-12","2025-09-30","2025-06-02","2025-07-25","2026-01-07","2025-11-12","2025-08-29","2025-07-21","2025-07-11","2025-08-29","2025-07-09","2025-07-10","2025-09-23","2025-07-08","2025-07-08","2025-07-08","2025-08-29","2025-07-25","2026-01-07","2025-11-12","2025-07-22","2025-09-01","2025-08-11","2025-09-23","2025-11-12","2025-09-23","2025-08-29","2025-09-23","2025-09-12","2025-09-12","2025-09-08","2025-09-08","2025-12-10","2025-12-11","2025-12-10","2024-12-29","2024-12-29","2024-12-29","2025-12-10","2023-08-29","2025-07-02","2025-08-29","2025-09-10","2025-10-30","2024-05-10","2025-07-25","2023-03-27","2023-08-29","2023-08-29","2023-08-29","2025-01-22","2025-12-12","2025-07-25","2025-07-12","2025-07-21","2025-07-20","2025-07-20","2025-11-12","2025-11-12","2025-08-29","2025-08-29","2025-09-02","2025-09-02","2026-01-20","2025-09-08","2025-09-08","2025-10-09","2025-09-16","2025-09-23","2025-09-23","2025-09-16","2025-12-10","2025-12-12","2025-12-12","2026-01-07","2026-01-07","2023-01-13","2025-12-23","2026-01-20","2026-01-20","2025-09-04","2026-01-20","2025-09-02","2025-09-12","2025-07-09","2025-08-29","2025-08-30","2025-07-10","2024-12-29","2024-01-16","2025-12-23","2023-06-01","2025-12-23","2023-06-01","2023-06-01","2025-05-07","2025-05-29","2025-07-09","2025-07-11","2025-07-11","2025-07-08","2025-07-13","2023-05-20","2025-03-14","2025-01-25","2025-04-09","2025-07-09","2025-08-11","2025-07-25","2025-12-10","2025-12-11","2025-12-11","2026-01-20","2024-12-28","2025-07-08","2025-07-08","2025-08-11","2025-09-02","2025-09-03","2025-09-03","2025-09-03","2025-09-03","2024-01-16","2024-12-28","2025-02-11","2025-05-29","2025-05-29","2025-06-03","2025-06-03","2025-07-21","2026-01-20","2022-08-04","2022-08-04","2025-07-11","2025-07-25","2025-09-01","2025-08-29","2025-09-03","2025-12-23","2025-12-23","2025-12-23","2022-09-27","2022-12-05","2025-01-22","2025-01-22","2025-05-29","2025-05-29","2025-07-07","2025-08-04","2025-09-04","2025-09-15","2024-12-30"],"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",""],["","","BREYNA","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","AMIODARONE HCL","","","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":""}]}]}