{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DUANE CARROLL","gend":0,"currentgend":"","add":"2515 S YATES ST","city":"DENVER","state":"CO","zip":"80219","dob":"1949-12-17","age":"","mstatus":"","insh":101857469,"cliId":"","pno":"3038887488","cno":"3038887488","email":"","ename":"","eno":"","pphy":"FISCHER, HENRY H","ppno":"","pcpadd":"3000 NEW BERN AVE,","pcpcity":"RALEIGH","pcpstate":"NC","pcpzip":"28289","pcpcounty":"","pcpid":"","pcpname":"WESTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2515 S YATES ST","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80219","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"101857469","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R2689","Z743","R410","G9340","F419","F32A","I129","E1122","E1140","N400","K219","E785","E039","M5450","H524","H52223","E11621","L97422","E1142","S91311D","F89","F09","F339","S91114A","L03115","L859","F3341","F79","R419","F6381","I4891","I499","R918","H25813","H2512","M7989","Z8781","Z98890","M65312","C44329","D225","Z0389","A419","J09X2","N179","E875","R479","G9349","F0390","I480","R4182","S22060A","H2511","Z01818","Z48810","H5704","R29898","H57813","R197","R413","S0990XA","L853","H5213","U071","M869","Z4781","G928","R4189","M4854XG","A4189","S0280XA","W19XXXA","L97512","E11628","R0902","H35371","H04123","E119","Z961","C44399","I4719","I4710","I4720","I4589","K6389","N3289","S90414D","Z89411","Z89421","R296","N289","S22068A","E1136","G319","S22068D","S22060D","R300","R1084","G5623","L03031","J9811","K5730","K449","I10","Z043","S22069A","W109XXA","F331","E118","R5383","M65322","R42","J101","S0291XA","R262","R531","J9600","G912","L0390","G929","M549","H52203","H33321","M4804","M9982","R609","Z7901","Z460","M898X7","Z89431","L603","Z4802","Z1211","N189","G629","M47814","M47816","R109","R0602","M40204","R29890","M4314","H02403","H5212","S22060S","M65332","M65342","R6520","J168","R519","M542","M25531","G8918","B351","H1013","R001","M40294","K6289","S020XXA","M810","S22058D","M4014","W19XXXS","R000","H538","Z794","S0219XD","W19XXXD","Z8631"],"date":["2023-04-19","2023-04-19","2023-01-19","2023-04-20","2023-04-16","2023-02-03","2023-02-03","2023-02-03","2025-09-26","2023-02-03","2023-02-03","2023-02-03","2023-09-26","2024-03-08","2025-06-05","2025-08-15","2023-04-26","2023-03-28","2026-01-10","2023-03-28","2023-03-31","2023-03-07","2023-03-07","2023-04-19","2023-04-19","2025-08-12","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2023-12-19","2026-01-09","2025-09-02","2023-09-13","2023-10-26","2024-05-30","2024-05-30","2025-01-28","2025-03-11","2025-11-21","2025-09-18","2026-01-08","2026-01-12","2026-01-12","2026-01-09","2026-01-09","2023-07-20","2023-07-20","2026-01-12","2025-07-15","2023-07-19","2023-04-19","2023-09-26","2023-09-13","2023-11-29","2024-05-29","2024-08-01","2024-08-05","2024-08-23","2025-02-12","2024-12-01","2025-06-03","2025-06-05","2025-09-01","2025-09-15","2025-10-22","2023-04-13","2023-07-18","2023-10-03","2026-01-08","2023-04-09","2024-12-01","2023-04-26","2023-04-26","2023-07-18","2025-08-15","2025-04-30","2025-10-22","2025-08-15","2025-06-17","2025-08-12","2025-08-12","2025-08-12","2025-08-12","2025-09-02","2025-09-02","2025-09-26","2025-09-26","2025-09-26","2026-01-12","2023-04-19","2023-09-28","2023-03-15","2023-04-24","2023-05-16","2023-11-03","2024-03-05","2024-12-24","2024-10-09","2025-08-18","2023-01-19","2023-01-19","2023-01-19","2025-09-12","2025-09-02","2023-04-21","2024-12-01","2023-05-01","2024-05-17","2024-07-24","2025-01-24","2025-09-29","2026-01-13","2023-04-21","2023-04-20","2023-04-21","2023-04-20","2023-04-20","2023-04-20","2023-04-18","2023-07-19","2025-06-05","2024-05-29","2023-09-28","2023-09-28","2023-09-28","2024-12-01","2025-06-05","2025-09-12","2025-09-12","2025-10-22","2025-10-22","2024-11-14","2023-01-26","2025-01-14","2023-03-05","2023-03-05","2023-03-05","2023-04-13","2023-09-05","2023-09-05","2023-09-05","2024-08-05","2025-08-15","2023-09-14","2025-01-24","2025-01-24","2026-01-08","2026-01-08","2024-12-01","2024-12-01","2024-12-01","2023-10-31","2023-03-08","2023-03-15","2023-04-17","2023-05-16","2023-07-19","2023-04-09","2023-05-17","2023-09-01","2023-09-01","2023-09-14","2025-09-02","2025-07-11","2024-10-09","2023-04-14","2023-04-14","2023-05-31"],"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",""],["","","CEPHALEXIN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","OXYCODONE 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":""}]}]}