{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"G SOTELO VDA DE IBANEZ","gend":1,"currentgend":"","add":"3700 W EXPOSITION AVE","city":"DENVER","state":"CO","zip":80219,"dob":"1948-11-30","age":"","mstatus":"","insh":"MEMO0000725371","cliId":"","pno":"7204365450","cno":"","email":"","ename":"","eno":"","pphy":"FISCHER, HENRY H","ppno":"","pcpadd":"3000 NEW BERN AVE,","pcpcity":"RALEIGH","pcpstate":"NC","pcpzip":27610,"pcpcounty":"","pcpid":"","pcpname":"WESTSIDE ADULT MEDICAL HOME","plan":"Denver Health","program":"Medicare","lob":"Event - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3700 W EXPOSITION AVE","madd2":"","madd3":"","mcity":"DENVER","mstate":"CO","mzip":80219,"pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5M56RU2CR87","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1122","E042","Z940","L600","M5431","R399","E1165","E119","C44319","M25562","Z1231","C029","T8613","R221","Z85810","H524","H52223","R195","K5730","K644","H25813","H04123","H5203","R410","Z743","A419","N12","R5383","R300","M25552","M79605","M810","E1159","E1169","Z794","I10","E785","K219","H9193","Z974","F419","M5416","H52203","D34","D440","Z460","Z08","S99921A","Z0000","N3000","Z79899","M25521","D849","Z1283","M79622","E1136","D229","M898X7","M2011","M21611","J9601","N10","K8020","K838","Z461","Z1289","E041","N390","R1030","K828","M533","R9431","Z87448","Z9049","R42","E663","Z6829","D84821","T8610","K6389","E278","G8929","Z4822","J989"],"date":["2025-11-12","2025-02-10","2025-11-21","2023-07-19","2025-09-23","2024-07-16","2025-02-11","2025-11-18","2025-12-05","2026-01-27","2022-05-29","2025-11-18","2025-01-23","2022-02-25","2025-02-10","2025-11-14","2025-11-14","2022-09-08","2022-09-08","2022-09-08","2025-11-14","2025-11-14","2025-11-14","2025-01-23","2025-01-23","2025-01-25","2025-01-23","2025-01-23","2025-01-23","2025-12-24","2025-12-24","2025-12-24","2024-07-30","2024-07-30","2024-07-30","2025-11-18","2024-07-30","2024-07-30","2024-07-30","2024-07-30","2024-07-30","2022-10-13","2025-11-14","2022-10-19","2022-10-19","2025-11-14","2024-08-05","2024-05-30","2025-08-27","2022-05-02","2022-11-22","2023-08-02","2024-09-17","2022-09-16","2023-02-02","2023-06-23","2023-09-18","2024-05-30","2024-05-30","2024-05-30","2025-01-25","2025-01-25","2025-01-23","2025-01-23","2024-02-09","2025-02-10","2022-02-25","2025-01-23","2025-01-23","2025-01-23","2025-12-29","2025-01-24","2024-07-30","2024-07-30","2024-07-30","2024-07-30","2024-07-30","2022-11-22","2025-01-23","2025-01-23","2025-01-23","2025-02-23","2024-03-19","2025-01-24"],"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",""],["","","MYCOPHENOLATE MOFETIL","","","Select","Select",""],["","","TACROLIMUS","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CEFDINIR","","","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":""}]}]}