{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda E Thurber","gend":1,"currentgend":"","add":"50 CALL OF THE LOON LN","city":"Alexander","state":"ME","zip":"04694","dob":"1953-01-14","age":"","mstatus":"","insh":"10000056969","cliId":"","pno":2078766154,"cno":"","email":"Lindathurber53@gmail.com","ename":"","eno":"","pphy":"RUSSELL, JACQUELINE","ppno":2079437752,"pcpadd":"CCH Family Medicine,37 Palmer St Ste 3","pcpcity":"Calais","pcpstate":"ME","pcpzip":"04619","pcpcounty":"","pcpid":"","pcpname":"CCH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"50 CALL OF THE LOON LN","madd2":"","madd3":"","mcity":"Alexander","mstate":"ME","mzip":"04694","pcpfaxno":2079431002,"pcpnpi":1730742107,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6T08JX9XE62","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","J45909","F418","I82891","I83893","G4700","J4541","F411","R413","Z23","R030","R0789","E782","Z131","Z130","Z1329","H524","Z0101","H2513","Z87891","Z122","R059","R062","Z1231","I82411","I83811","I83891","R079","B078","D485","I83813","D1801","M8589","E785","Z13220","Z800","I83812","I83892","Z8371","K5730","R6889","D225","D2272","L578","L814","L821","I8390","Z87898","Z0001"],"date":["2025-06-18","2024-09-11","2024-10-23","2024-07-08","2024-07-08","2023-09-06","2023-10-10","2023-09-06","2023-09-27","2023-09-06","2024-03-19","2024-10-09","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2024-04-03","2024-04-03","2024-04-03","2024-08-27","2024-08-27","2023-10-10","2023-10-10","2025-09-04","2024-06-28","2025-04-29","2024-06-26","2024-08-22","2023-07-13","2023-07-13","2025-04-29","2023-07-13","2024-08-16","2024-06-11","2024-06-11","2022-06-28","2022-07-07","2022-07-06","2022-06-28","2022-06-28","2022-04-07","2021-12-07","2021-12-07","2021-12-07","2021-12-07","2021-12-07","2022-02-01","2022-02-01","2022-02-01"],"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":[["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","ADVAIR HFA","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","FLUTICASONE-VILANTEROL","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL HFA","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","COMBIVENT RESPIMAT","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","FLOVENT HFA","","","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":""}]}]}