{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ENRIQUE SMITH","gend":0,"currentgend":"","add":"824 S ONEIDA ST","city":"DENVER","state":"CO","zip":"80224","dob":"1973-07-20","age":"","mstatus":"","insh":2000054141,"cliId":"","pno":"7202910862","cno":"7202910862","email":"","ename":"","eno":"","pphy":"NO PCP","ppno":9706251100,"pcpadd":"501 AIRPORT RD,","pcpcity":"RIFLE","pcpstate":"CO","pcpzip":"81650","pcpcounty":"","pcpid":"","pcpname":"LOWRY FAM MED MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT F215","add3":"","madd1":"824 S ONEIDA ST","madd2":"APT F215","madd3":"","mcity":"DENVER","mstate":"CO","mzip":"80224","pcpfaxno":9706250725,"pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2000054141","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S82142A","L02416","T8131XA","L03114","M5136","N50811","Z113","R55","F259","Z464","S82142D","F209","M059","N3000","N4889","T84623A","S8292XD","M869","T84623D","T8131XD","M5450","L03116","S51002A","R1013","M86662","A4102","A419","R7881","K6812","M0009","S6991XA","L03011","R0602","R600","D708","N289","R7301","Z5181","E079","R053","R062","Z23","B351","G8929","N50812","Z0000","Z1211","Z131","Z13220","Z1159","E669","E559","R300","H6122","I889","B356","G928","N179","N400","J45909","I9789","G250","E039","G40909","G2589","B20","R112","K5900","Z91199","F205","R770","R739","E871","I10","Z9689","Z029","S8992XA","S81809A","L089","Z743","M00062","R000","R748","D649","T8142XA","M86462","S82142S","L97921","D509","M25462","M2540","Z6841","R7303","F203","Z472","B9689","S81802D","M00862","B9562","T8142XD","B961","B964","Z01810","I4711","Z481","M1712","M79662","S51002D","L608","K760","F840","R52","R4182","F29","D72829","J189","L02419","R945","A4902","Z792","M4620","M4626","L259","F319","R262","M0000","L659","E119","K5732","K689","T50905D","R251","T1490XA","L0291","D75839","G8911","W002XXA","B353","R609","L853","E785","E11628","M7989","M79605","B9561","B957","R918","F6089","Z4789","S82202S","S82402S","T81328A","R37","R030","M47816","R079","K651","R7401","R7989","M60862","R6520","M4646","M009","M4636","A1801","M5127","M51369","F4310","R410","Z1212","R2689","Z789","Z96698","M898X6","I517","M25562","T8149XA","Z888","E6601","Z6842","S83262A","T8189XA","R451","M75122","M25412","M67813","E8809","M60861","G062","I3139","M79644","G2570","Z4689","S82122A","S82132A","W009XXA","M86152","M79606","R531","R456","F609","J15212","S29011A","F99","R110","R7981","R627","I253","D174","L600"],"date":["2024-11-18","2025-10-18","2025-06-02","2022-03-05","2022-11-21","2023-01-09","2024-01-10","2024-01-10","2023-12-22","2024-04-01","2024-06-13","2026-01-27","2024-05-14","2024-05-25","2024-08-23","2024-11-18","2024-04-26","2024-12-16","2024-12-26","2025-08-01","2025-12-05","2025-04-21","2025-06-16","2025-06-26","2025-08-23","2025-12-05","2025-09-26","2026-01-09","2026-01-28","2025-11-21","2022-01-03","2022-11-14","2025-06-26","2022-03-04","2025-08-13","2025-08-13","2025-08-13","2025-12-19","2025-01-17","2022-11-21","2022-11-21","2023-08-07","2024-01-10","2025-12-05","2023-01-09","2023-08-07","2023-08-26","2023-08-07","2023-08-07","2023-08-07","2024-05-14","2025-12-19","2023-08-07","2023-08-07","2023-10-03","2023-09-27","2023-12-23","2025-11-17","2023-12-23","2024-11-26","2024-03-08","2024-11-15","2025-12-18","2025-12-18","2024-02-29","2024-02-29","2024-03-04","2024-03-04","2024-03-20","2024-04-24","2024-03-20","2024-03-20","2025-11-20","2025-12-29","2024-02-27","2026-01-22","2024-02-17","2024-11-07","2024-11-12","2025-10-18","2024-11-25","2025-10-13","2024-11-16","2024-11-27","2024-12-26","2024-11-12","2024-12-20","2024-11-06","2025-12-10","2025-09-25","2024-12-11","2025-11-10","2024-11-27","2024-11-27","2025-03-21","2024-11-08","2025-02-06","2024-12-13","2025-12-19","2025-01-30","2024-12-26","2024-12-26","2024-12-12","2024-12-12","2025-08-01","2025-03-21","2025-03-21","2025-06-16","2025-06-16","2025-10-20","2025-11-28","2025-09-23","2025-09-27","2025-09-27","2025-10-04","2025-10-07","2025-10-15","2025-10-14","2025-10-18","2025-12-19","2025-11-14","2026-01-09","2025-11-26","2025-12-17","2025-12-15","2025-12-19","2025-12-19","2025-12-19","2025-12-22","2025-12-22","2026-01-24","2024-01-10","2024-01-10","2024-04-01","2024-03-11","2024-02-17","2024-02-27","2024-04-14","2024-04-14","2022-03-16","2025-08-13","2022-03-05","2025-10-11","2024-11-06","2025-11-17","2024-11-12","2024-11-15","2024-11-19","2024-12-11","2025-04-21","2025-04-21","2024-12-17","2025-02-06","2025-02-06","2025-04-09","2025-06-26","2025-11-07","2025-10-07","2025-10-18","2025-11-07","2025-10-18","2025-11-14","2025-10-07","2025-11-24","2025-10-08","2025-10-08","2025-10-08","2026-01-27","2023-12-22","2023-08-26","2024-04-10","2024-05-14","2024-11-07","2024-12-17","2024-11-08","2024-11-07","2024-12-20","2024-12-19","2025-11-17","2025-10-07","2024-02-27","2024-03-12","2024-11-16","2025-10-09","2025-10-09","2025-10-09","2025-11-13","2025-11-07","2025-11-05","2025-09-24","2022-01-03","2024-03-04","2024-04-01","2024-02-16","2024-02-16","2024-02-16","2024-11-18","2025-10-02","2025-11-07","2024-03-19","2024-11-18","2025-09-29","2025-11-28","2024-03-18","2024-03-11","2025-09-27","2025-09-23","2025-09-27","2025-09-27","2025-11-12"],"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":[["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TERBINAFINE HCL","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","DIVALPROEX SODIUM ER","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}