{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YOLANDA ROMERO","gend":1,"currentgend":"","add":"5120 BROADWAY APT 401","city":"DENVER","state":"CO","zip":80216,"dob":"1961-06-10","age":"","mstatus":"","insh":"MEM00000203941","cliId":"","pno":"7207500715","cno":"","email":"","ename":"","eno":"","pphy":"TREFILEK, BENJAMIN T","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"EASTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"Event - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5120 BROADWAY APT 401","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":80216,"pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6J41YU0FT17","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N186","N361","R0600","N179","M810","M25562","E278","R768","N178","L309","N760","T82898A","T82510A","Z23","T82510D","H401232","F32A","G629","E1142","E875","R079","N390","H25813","N3001","N200","R936","I5032","K920","T8140XA","R109","Z4931","I132","H47393","I120","R5383","T8241XA","E1122","Z48812","N1831","R3915","I3139","R188","N184","Z01818","I071","I130","D472","Z9981","G4733","R300","Z029","Z992","I770","J9601","I2720","E669","R9431","T829XXA","N269","N051","N211","K660","Z87440","R100","Z743","R58","R52","Z452","D631","E871","T82598A","E889","I871","D539","N189","E861","E8770","E119","R32","E6601","I509","R531","R0902","N99820","R000","I129","E1121","N041","E1165","F17210","J449","N1830","E1169","E785","I252","Z955","F324","G8929","I10","Z1231","R809","R808","Z0189","N2889","M7989","I5030","N185","E8720","R0602","I110","R059","R058","N10","B9620","Z1612","Z7409","Z95828","J811","Z792","J189","R7989","K7689","K5730","T8249XA","I25119","I517","M1990","E261","R918","J90","N281","S8992XA","W19XXXA","Z967","Z98890","I499","E839","A419","R1110","K439","R062","K429","Z905","R1031","M5489","R350","K91841","K91873","K922","R252","R112","Z1211","R110","Z01810","I3481","I700","Z4901","R0789","N12","N202","H04123","J45909","N289","T82848D","N3289","R601","G8918","R222","S81802D","M898X9","E874","N250","E8339","R051","I340","I371","I878","K5732","N8184","J9621","R200","Z0389","M79671","R3129","N368","N3080","D649","S36118A"],"date":["2026-01-14","2026-01-27","2022-03-22","2024-08-26","2023-11-21","2024-11-20","2025-11-12","2025-09-26","2023-10-10","2024-01-26","2025-02-16","2025-09-08","2025-09-09","2025-10-02","2025-12-02","2025-12-04","2025-10-30","2025-11-21","2025-12-02","2025-11-13","2025-11-12","2025-06-23","2025-05-06","2025-04-28","2025-11-06","2025-05-13","2026-01-01","2025-06-15","2025-06-14","2025-08-16","2025-10-28","2025-08-19","2025-08-26","2025-09-09","2024-12-17","2025-02-27","2025-09-09","2025-04-15","2025-03-26","2024-10-02","2023-12-01","2023-12-07","2024-08-27","2025-01-13","2024-06-27","2024-08-25","2025-03-26","2025-11-13","2024-10-09","2025-01-21","2026-01-27","2025-11-13","2025-10-28","2026-01-01","2026-01-01","2025-09-09","2025-11-12","2025-05-26","2025-06-10","2025-06-10","2025-06-10","2025-06-10","2025-06-10","2025-06-14","2025-11-12","2025-06-14","2025-09-08","2025-09-09","2025-09-09","2025-11-12","2025-09-09","2025-09-09","2025-09-10","2025-09-26","2025-09-25","2025-11-12","2025-11-12","2025-11-25","2025-11-25","2025-11-25","2025-11-25","2025-11-12","2023-10-11","2023-10-11","2023-10-11","2024-07-21","2023-10-31","2023-10-11","2024-06-11","2024-06-11","2024-07-21","2024-07-21","2024-07-21","2024-10-31","2025-06-30","2024-07-21","2024-07-21","2023-08-16","2025-06-11","2023-01-06","2023-10-12","2023-09-19","2025-05-26","2025-08-25","2023-12-07","2024-08-26","2025-11-21","2024-08-26","2024-08-25","2024-10-31","2025-06-16","2024-12-17","2025-03-27","2025-02-11","2025-02-11","2025-07-29","2025-02-04","2025-06-16","2025-04-10","2024-12-19","2025-06-15","2025-08-25","2025-08-25","2025-09-08","2023-03-31","2024-06-27","2024-07-21","2024-07-21","2025-06-16","2025-11-12","2025-11-12","2024-08-28","2024-08-28","2024-08-28","2025-06-23","2025-02-26","2025-06-11","2025-06-14","2025-06-14","2025-06-14","2025-06-16","2025-06-23","2025-11-06","2025-06-23","2025-06-23","2025-06-23","2025-06-14","2025-06-14","2025-06-26","2025-03-07","2025-11-12","2023-01-31","2024-03-14","2025-06-10","2024-06-27","2024-06-27","2024-08-28","2025-03-18","2025-03-06","2025-04-28","2025-05-06","2023-01-18","2025-11-06","2025-05-13","2025-11-12","2025-11-12","2023-11-21","2023-11-21","2022-06-09","2024-06-18","2024-06-18","2025-06-15","2025-06-15","2025-01-21","2023-04-01","2023-04-01","2023-04-01","2025-02-09","2025-02-09","2025-11-13","2025-10-28","2025-11-12","2023-04-27","2023-12-21","2023-12-21","2023-12-21","2025-04-02","2025-06-23"],"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":[["","","SPIRONOLACTONE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","LOKELMA","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","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":[]}},{"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":{"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":""}]}]}