{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOROTHY JAMES","gend":1,"currentgend":"","add":"14400 E FREMONT AVE","city":"ENGLEWOOD","state":"CO","zip":"80112","dob":"1950-01-10","age":"","mstatus":"","insh":1020732098,"cliId":"","pno":"3035965629","cno":"3035965629","email":"","ename":"","eno":"","pphy":"HULINGS, JOEDY E","ppno":8014290629,"pcpadd":"1055 NORTH 500 WEST,","pcpcity":"PROVO","pcpstate":"UT","pcpzip":"84130","pcpcounty":"","pcpid":"","pcpname":"PARK HILL FAM MED MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"BLDG 12 APT 103","add3":"","madd1":"14400 E FREMONT AVE","madd2":"BLDG 12 APT 103","madd3":"","mcity":"ENGLEWOOD","mstate":"CO","mzip":"80112","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1020732098","medicaidid":"","pcpFlag":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N179","G8929","M5450","S60312A","R634","W268XXA","Z029","J9811","M7910","F17210","I10","R29898","I639","D539","I214","F1410","Z86718","Z8673","Z7901","Z905","R0602","R778","R079","N1830","I82409","R600","N1832","I517","J9690","I509","L03116","M5430","R2689","F331","H5203","H524","H2513","Z135","I130","I5020","N189","I2510","R0600","Z720","D509","K31A0","K449","K649","Z760","J449","I1310","R918","Z743","R9431","A419","J984","R0989","J9809","I110","Z87891","I2720","Z9049","Z515","J189","J9621","J9622","I25118","H35033","M11261","R296","I82442","F332","Z09","I161","L602","R5381","Z23","I252","R1011","K5900","I3481","K2970","H903","Z0000","L600","L603","M2012","M2011","M2550","I493","I444","M25461","M25561","Z9181","E785","Z602","Z6825","R52","Z20822","M79672","I82402","D61818","I82432","I82412","R5383","I21A1","B20","Z66","I739","K31A19","I5040","R0902","I70203","I5033","I2729","D631","M79605","K922","N281","J441","E875","J15212","E6601","I824Z1","I5A","R100","B182","M7989","Z461","L03115","R2990","M25542","R911","R748","R45851","T405X4A","F29","R531","N2889","I82441","I82453","I5032","D531","I132","N185","J440","J188","R000","M5440","G629","S92353P","F3341","I280","I3489","R9439","I340","I878","M25475","I63542","I491","R2243","R93422","R0781","R791","T1490XA","I6503","B353","N1831","D649","N289","E8770","J9602","F17200","E860","T33532A","M79604","J9611","N184","Z993","M1711","T33522A","I5030","I059","I071","R0683","S6992XA","R2241","R030","R0609"],"date":["2026-01-20","2025-06-06","2025-12-11","2022-01-25","2022-01-25","2022-01-25","2025-11-10","2025-09-26","2022-02-23","2022-02-23","2025-11-11","2022-12-01","2022-12-02","2025-11-05","2023-05-16","2023-05-15","2025-11-05","2025-11-05","2023-02-15","2025-12-09","2025-11-03","2023-02-16","2025-11-01","2025-12-11","2023-02-16","2025-11-01","2025-12-03","2025-09-05","2023-02-21","2025-12-08","2023-02-25","2023-02-25","2023-02-25","2023-05-13","2024-08-07","2023-08-01","2024-08-07","2023-08-01","2026-01-12","2025-12-16","2025-12-09","2025-11-12","2025-08-23","2024-10-02","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2025-07-05","2026-01-29","2025-07-28","2025-10-16","2025-11-01","2025-12-04","2025-11-01","2025-11-01","2025-11-01","2025-11-01","2026-01-12","2025-11-12","2026-01-12","2025-11-12","2026-01-20","2025-11-05","2025-11-05","2025-11-05","2023-03-09","2024-08-07","2022-03-15","2022-04-06","2022-11-30","2023-05-15","2023-05-25","2023-05-16","2023-07-20","2025-07-02","2024-04-02","2024-09-09","2024-09-05","2024-09-03","2025-09-05","2024-10-24","2025-09-04","2026-01-09","2022-01-31","2022-01-31","2022-01-31","2022-01-31","2022-02-08","2022-03-04","2022-03-04","2022-03-03","2022-03-03","2022-03-16","2023-05-16","2022-03-16","2022-03-16","2022-11-30","2023-05-16","2022-11-30","2022-12-01","2022-11-30","2022-11-30","2022-11-30","2025-11-13","2023-05-16","2023-03-09","2025-10-11","2025-01-30","2024-10-29","2026-01-29","2026-01-29","2025-09-26","2025-12-04","2025-10-14","2025-12-10","2025-09-26","2025-10-14","2025-10-13","2025-11-05","2025-11-05","2025-11-05","2025-11-05","2025-11-02","2025-11-02","2023-02-11","2024-05-28","2025-09-11","2025-03-03","2025-11-11","2022-12-01","2022-12-22","2023-02-11","2023-05-15","2023-05-15","2023-05-15","2023-05-15","2024-03-04","2025-08-26","2025-11-01","2025-11-01","2026-01-12","2025-12-09","2025-12-10","2025-12-10","2025-11-01","2025-11-01","2025-11-01","2025-07-02","2025-07-02","2025-01-30","2023-07-26","2022-12-01","2022-12-01","2023-02-14","2023-02-14","2023-02-14","2022-11-30","2022-11-30","2024-03-18","2025-07-26","2025-12-09","2022-02-23","2022-02-23","2023-03-06","2022-11-30","2023-02-06","2023-05-16","2025-10-21","2023-05-12","2025-10-16","2025-10-11","2025-10-11","2025-12-08","2022-12-22","2022-03-03","2025-10-11","2025-12-08","2022-01-19","2022-02-08","2022-12-22","2024-09-19","2025-09-05","2025-09-05","2024-10-16","2022-12-22","2023-03-06","2023-05-18","2024-08-15"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","SPIRIVA HANDIHALER","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","HYDRALAZINE 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":""}]}]}