{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"William F Lucatuorto","gend":0,"currentgend":"","add":"239 LINCOLN ST","city":"SOUTH PORTLAND","state":"ME","zip":"04106","dob":"1953-07-14","age":"","mstatus":"","insh":"10000061859","cliId":"","pno":3038879164,"cno":"","email":"wild.billlucy@gmail.com","ename":"","eno":"","pphy":"MARINO, RICHARD T","ppno":2078742466,"pcpadd":"190 RIVERSIDE ST UNIT 6B,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41031073","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH SENIOR CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"239 LINCOLN ST","madd2":"","madd3":"","mcity":"SOUTH PORTLAND","mstate":"ME","mzip":"04106","pcpfaxno":2077744625,"pcpnpi":1285665828,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4M51NA0FK21","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S42291D","M25559","S32591A","V2999XA","M25511","M7541","H35372","Z23","Z0000","E785","E039","Z1211","S42201A","H524","E119","E041","S3991XA","S3993XA","S299XXA","S199XXA","S0990XA","S62346A","S32491D","S3289XD","I4719","R55","I498","D225","D492","L578","L814","L821","R7401","H401134","D120","Z86010","D122","D123","H401131","H353130","S32434D","S32434A","S32511A","Z20822","S62346D","H401132","F1090","S42221A","S42291A","S42134A","F1010","S32401D","S32511D","S32391D","Z1389","L570","S32301D","H1033","R590","I517","S7291XA","M25551","Z8781","Z125","I2510","E7800","E669","Z6831","Z7984","S32401A","E042","R262","Z736","V892XXA","S329XXA","T148XXA","H6992","S43401A","E0789"],"date":["2025-07-23","2023-04-14","2023-04-14","2023-04-14","2025-11-19","2025-11-19","2025-03-13","2023-03-07","2025-04-17","2025-04-17","2025-05-02","2024-05-01","2025-07-23","2025-11-14","2025-11-13","2024-12-16","2023-04-14","2023-04-14","2025-05-01","2025-05-01","2025-05-01","2023-04-25","2023-05-02","2023-07-11","2025-06-09","2025-09-12","2025-06-09","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2025-07-11","2022-12-21","2024-05-01","2024-05-01","2024-05-01","2024-05-01","2024-11-13","2023-03-30","2023-05-30","2023-04-14","2023-04-14","2023-04-14","2023-05-01","2023-11-07","2025-05-02","2025-05-02","2025-05-01","2025-05-01","2025-05-01","2023-05-30","2023-05-30","2023-05-30","2023-08-07","2025-06-18","2023-05-02","2023-09-18","2023-08-22","2025-05-02","2023-04-19","2023-04-19","2025-07-17","2024-03-12","2025-09-12","2025-09-12","2024-09-05","2024-09-05","2024-09-05","2023-04-14","2024-12-16","2023-04-25","2023-04-25","2023-04-26","2023-04-26","2023-04-26","2024-04-18","2025-05-01","2023-07-10"],"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":[["","","SYNTHROID","","","Select","Select",""],["","","TIMOLOL MALEATE","","","Select","Select",""],["","","BRIMONIDINE TARTRATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","ETODOLAC","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","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":{"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":""}]}]}