{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBIN MITCHELL","gend":0,"currentgend":"","add":"1380 DETROIT ST","city":"DENVER","state":"CO","zip":"80206","dob":"1942-12-18","age":"","mstatus":"","insh":101491306,"cliId":"","pno":"7203397195","cno":"7203397195","email":"","ename":"","eno":"","pphy":"KOLPAK, STEVEN J","ppno":3037551116,"pcpadd":"1450 S HAVANA ST,SUITE 436","pcpcity":"AURORA","pcpstate":"CO","pcpzip":"02284","pcpcounty":"","pcpid":"","pcpname":"DH PAV G ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 619","add3":"","madd1":"1380 DETROIT ST","madd2":"APT 619","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80206","pcpfaxno":8124250624,"pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"101491306","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z029","E1142","R269","Z7984","E1136","M549","K219","N400","E663","E785","Z602","Z483","J939","R1310","K225","K3189","D509","K5730","H401230","Z0389","R918","Z978","Z95828","R000","R008","I2699","I82412","I82220","K8689","R9431","I2129","I493","K869","N179","N1832","D649","I25118","E782","Z23","J984","H5213","H52223","H524","Z961","G5621","G5601","E1169","H353122","H353111","J449","E119","C7A090","H409","Z6828","M6281","Z9181","H401232","I10","R911","E118","D500","M5450","E875","N1830","N170","R079","R600","I252","J95811","D6489","G5602","Z0184","G9340","I081","I3139","I878","G928","I82402","E1122","I129","D631","J432","Z720","Z86711","G5622","E1342","M5416","H35373","Z131","R2689","Z743","M25512","J189","I2510","H26491","Z87891","Z4682","J9811","C3490","G9341","I959","J9601","E870","J690","Z452","N281","S32010G","R9439","Z48811","M5386","M4696","Z0189","I6523","Z48815","R4182","E8720","T373X1A","J90","I5030","I517","E1140","H35362","I872","R1312","H04123","I509","J439","J84117","H26493","C3412","N261","K5790","R1313","R410","E43","I214","R7989","A419","R578","R6521","N189","I2584","I2582","E1121","Z122","J9383","Z98890","M4856XG","M5136","M48061","M9983","N2889","E88810","I69918","I82422","I82432","I82442","R0609","I4430","I130","K449","K2289","R109","E8889","R29818","J8410","M25812","M25712","R1011","R790","G609","R1013"],"date":["2026-01-22","2023-02-21","2022-07-27","2022-07-27","2022-07-27","2024-07-18","2022-07-27","2024-05-31","2024-04-17","2022-07-27","2022-07-27","2023-04-27","2024-07-23","2024-06-08","2025-09-08","2023-07-17","2025-10-23","2023-11-20","2025-11-18","2024-04-10","2025-10-23","2024-04-10","2024-06-03","2024-07-03","2024-06-02","2024-07-03","2024-07-03","2024-06-02","2024-06-02","2024-07-04","2024-07-03","2025-10-02","2024-07-03","2024-07-09","2025-01-14","2025-10-23","2024-10-29","2025-10-02","2025-02-14","2025-03-20","2025-04-22","2025-04-22","2025-04-22","2025-05-06","2026-01-13","2026-01-13","2026-01-07","2025-12-17","2025-12-17","2024-04-17","2025-12-17","2024-04-17","2024-04-17","2024-04-17","2024-04-17","2024-04-17","2022-09-27","2025-09-02","2023-03-23","2024-05-23","2024-08-20","2024-05-09","2024-08-20","2024-07-11","2024-07-02","2024-07-25","2024-08-06","2025-11-07","2024-04-09","2025-10-14","2025-12-01","2025-12-30","2024-07-31","2023-05-11","2023-05-11","2023-05-11","2024-06-01","2024-06-02","2024-07-30","2024-07-30","2024-10-22","2024-10-22","2025-01-06","2024-10-21","2025-12-01","2025-12-01","2025-12-01","2025-12-17","2023-10-04","2025-09-08","2024-06-08","2024-10-14","2025-01-06","2025-11-07","2025-05-06","2023-02-08","2023-03-24","2023-03-24","2023-03-23","2024-06-07","2024-06-05","2024-06-05","2024-06-07","2024-06-07","2024-07-03","2024-07-03","2024-08-27","2025-10-02","2026-01-22","2024-05-15","2024-05-15","2024-06-04","2024-06-01","2024-06-01","2024-06-01","2024-07-09","2024-07-02","2024-07-25","2025-11-07","2024-08-22","2025-10-01","2025-11-18","2023-02-01","2023-08-31","2025-05-06","2025-11-25","2025-01-06","2023-06-22","2023-09-15","2024-04-09","2024-05-31","2024-05-31","2024-06-03","2024-06-03","2024-06-03","2024-07-06","2024-07-03","2024-07-03","2024-07-05","2024-07-03","2024-08-12","2024-07-03","2024-07-03","2025-01-14","2022-12-07","2023-03-23","2024-05-16","2024-05-29","2024-05-29","2024-05-29","2024-05-29","2024-05-31","2024-06-02","2024-05-31","2024-05-31","2024-05-31","2024-05-31","2025-10-02","2025-10-02","2025-11-07","2023-08-31","2023-08-31","2024-06-01","2024-06-01","2022-04-06","2023-09-26","2024-09-06","2024-09-06","2025-09-11","2025-09-08","2025-09-08","2025-09-11"],"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":[["","","LATANOPROST","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","TIMOLOL MALEATE","","","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":""}]}]}