{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sharon A Wilson Barker","gend":1,"currentgend":"","add":"643 NORTH RD","city":"DIXMONT","state":"ME","zip":"04932","dob":"1952-12-01","age":"","mstatus":"","insh":"10000061260","cliId":"","pno":2072342062,"cno":2079917863,"email":"anniet4556@gmail.com","ename":"","eno":"","pphy":"CAMERON, DARLA N","ppno":2078620300,"pcpadd":"C\/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT,PO BOX 7291","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"643 NORTH RD","madd2":"","madd3":"","mcity":"DIXMONT","mstate":"ME","mzip":"04932","pcpfaxno":2079071041,"pcpnpi":1639188758,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7EH9DW3UX53","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R7989","M25511","M25611","S42291A","R531","M7751","L570","D225","L814","L821","L700","R2231","M25641","R350","L659","E039","R5382","J4541","L255","L282","L02215","S42211A","S42251A","R52","H18593","H16323","H16223","H04123","Z8349","H40013","H1033","J4520","J4540","B370","M810","H9193","Z0000","J0190","B9689","Z08","K7400","R6889","Z780","H01001","R300","H16321","S99921A","Z98890","L820","L538","D1801","L720","Z148","H90A21","H903","J45909","J301","E782","S43401A","D485","S42291D","Z85828","R208","G5601","R030","N952","M79671","S60551A","N762","L298","S4991XA","W19XXXA","S42201A","N390","D2262","D2261","M25552"],"date":["2024-07-25","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-04-30","2024-11-19","2025-04-03","2025-10-06","2025-10-06","2024-11-19","2025-09-02","2025-09-02","2024-03-14","2024-03-14","2024-03-14","2024-03-14","2025-04-17","2023-09-08","2023-09-06","2023-09-05","2025-06-07","2025-06-07","2023-09-05","2025-06-05","2025-04-18","2025-06-05","2025-06-05","2024-04-01","2024-02-13","2025-02-03","2023-12-20","2025-02-03","2024-01-04","2025-03-20","2023-04-04","2023-04-04","2025-02-03","2025-02-03","2025-04-03","2024-07-25","2023-01-18","2025-03-20","2023-03-13","2024-05-26","2025-02-25","2025-05-09","2024-05-30","2025-10-06","2025-10-06","2025-10-06","2025-10-06","2023-04-14","2025-10-01","2025-07-16","2024-01-05","2025-05-20","2024-05-23","2025-06-07","2025-04-03","2025-09-02","2023-04-26","2023-04-26","2025-09-02","2025-01-20","2025-01-20","2025-04-30","2025-01-10","2023-09-21","2023-11-01","2025-06-04","2025-06-04","2025-06-07","2022-11-11","2022-10-19","2022-10-19","2022-08-11"],"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":[["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","RESTASIS","","","Select","Select",""],["","","ARNUITY ELLIPTA","","","Select","Select",""],["","","CALCITONIN-SALMON","","","Select","Select",""],["","","XIIDRA","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","LOTEPREDNOL ETABONATE","","","Select","Select",""],["","","CYCLOSPORINE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","PULMICORT FLEXHALER","","","Select","Select",""],["","","MEDROXYPROGESTERONE ACETATE","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","LOTEMAX","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":""}]}]}