{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MONA BOSHEY","gend":1,"currentgend":"","add":"1408 WINONA CT","city":"DENVER","state":"CO","zip":"80204","dob":"1960-02-12","age":"","mstatus":"","insh":1020878332,"cliId":"","pno":"7202245700","cno":"7202245700","email":"","ename":"","eno":"","pphy":"KULASEKARAN, VISHNU","ppno":3035469158,"pcpadd":"10345 PARKGLENN WAY STE #220,","pcpcity":"PARKER","pcpstate":"CO","pcpzip":"80308","pcpcounty":"","pcpid":"","pcpname":"DH PAV G ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1408 WINONA CT","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80204","pcpfaxno":3038408928,"pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1020878332","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1711","Z96652","Z029","H2513","H04123","H5213","H52203","M26623","M8918","I10","Z4682","R918","Z4659","R7881","B9561","K1120","L089","R52","L0201","L0211","R339","Z0189","K113","R001","D649","Z96659","M26641","M7989","Z96653","G8918","Z4889","J9601","R451","K122","I5030","R600","A4901","R220","K118","I110","N952","R110","T451X5D","K5900","I509","J449","K219","E785","G4700","M25461","Z96651","M5136","M47816","M152","M069","Z9181","G4730","R42","E559","E663","Z6833","Z79899","H52223","M19012","M5417","M0609","M818","M810","T372X5S","F17210","Z7983","Z1231","R92323","M25561","R0609","Z720","R0602","Z743","F1021","G8929","N179","G929","F1490","D72829","J189","J690","F1120","R1311","G319","R4182","R188","K838","M0600","M170","M25569","R7989","H6091","H663X1","M5441","M25529","Z461","H43391","N950","L309","Z20822","J069","M5440","M25512","F331","E041","G9349","Z1211","H903","L03311","A021","M25521","Z471","M1990","M79604","L299","Z6823","Z122","R0600","I700","G9340","L03818","R1013","F329","F1593","M793","R931","A419","R0902","R059","R109","R7401","F1520","R1084","R509","A020","A0811","M180","M19042","M19041","J984","Z87891","M48061","M26622","M79661","Z23","R21","F4321","F17200","E0590","Z4789","I081","I313","F32A","M5126","M4156","E042","L304","I159","R9431","A0839","Z605","M06011","R030","Z5181","M5450","Z452","I959","M5137","M9983","Z0000","H5319","R94131","I517","R590","R9389","R1900","R197","M5430","Z780","R29898","E860","G928","E43","E8339","K6389","N2889","R100","A09","R0989"],"date":["2022-08-30","2025-11-01","2026-01-23","2025-06-17","2025-06-17","2025-06-17","2022-03-02","2022-03-21","2022-03-21","2025-11-18","2022-04-26","2025-11-02","2022-04-26","2022-05-18","2022-05-18","2022-06-15","2022-04-13","2025-11-01","2022-04-27","2022-05-11","2022-04-10","2022-04-26","2022-04-27","2025-08-05","2022-04-26","2022-04-14","2022-05-04","2022-04-26","2024-10-11","2022-06-14","2022-04-14","2022-04-15","2022-04-15","2022-04-15","2025-11-03","2022-04-22","2022-06-15","2022-04-10","2022-04-25","2024-10-11","2024-10-11","2024-10-11","2022-06-04","2024-10-11","2024-10-11","2025-11-03","2024-10-11","2024-10-11","2022-06-04","2023-06-26","2023-06-26","2024-01-16","2022-09-13","2022-06-04","2025-08-06","2024-10-11","2024-10-11","2024-10-11","2024-10-11","2022-06-04","2022-06-04","2026-01-14","2025-06-17","2026-01-23","2025-03-17","2025-02-17","2025-02-17","2025-08-17","2024-10-11","2024-10-11","2025-02-17","2025-04-18","2025-04-18","2025-05-27","2025-06-19","2026-01-14","2025-08-04","2025-12-15","2025-08-05","2025-10-07","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-08-07","2025-11-01","2025-11-03","2025-12-17","2025-12-26","2026-01-14","2025-08-21","2022-05-17","2022-11-22","2022-10-19","2022-10-21","2025-05-26","2022-12-07","2022-11-30","2023-01-12","2023-08-22","2023-09-27","2023-12-04","2023-12-20","2025-09-16","2024-07-16","2025-07-22","2025-07-10","2025-08-04","2025-07-17","2025-09-29","2025-12-06","2025-12-15","2022-10-12","2022-06-13","2024-10-11","2024-10-11","2024-10-11","2024-10-11","2024-12-30","2025-08-04","2025-08-04","2025-12-19","2025-11-03","2025-11-03","2025-11-03","2025-11-01","2025-11-01","2025-11-01","2025-11-06","2025-12-15","2025-12-15","2025-12-21","2025-12-19","2025-12-19","2025-12-26","2025-12-24","2025-12-26","2025-12-26","2026-01-15","2026-01-15","2026-01-15","2024-01-10","2024-01-10","2024-09-20","2022-05-03","2025-05-27","2023-10-17","2024-03-05","2025-02-25","2022-03-16","2022-03-16","2022-05-16","2022-04-14","2022-04-14","2022-03-29","2024-09-20","2024-09-20","2025-07-10","2025-11-01","2025-11-01","2025-12-16","2025-12-21","2025-11-17","2022-03-28","2023-08-31","2023-08-25","2023-12-28","2022-04-26","2022-06-15","2022-10-03","2022-10-03","2022-10-19","2023-01-12","2023-03-13","2025-08-05","2022-04-10","2022-04-10","2022-04-26","2022-05-18","2025-05-26","2025-01-15","2025-12-26","2025-12-26","2025-12-26","2025-12-26","2025-12-26","2025-12-26","2025-12-26","2025-12-15","2026-01-06","2023-12-20"],"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":[["","","FLUZONE QUAD 2023-2024","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","CIPROFLOXACIN-DEXAMETHASONE","","","Select","Select",""],["","","FLUCELVAX QUAD 2022-2023","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","FLUCELVAX TRIVALENT 2024-2025","","","Select","Select",""],["","","SHINGRIX","","","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":""}]}]}