{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL R KILLION","gend":0,"currentgend":"","add":"5300 NW Hoch Rd","city":"Silver Lake","state":"KS","zip":"66539","dob":"1951-02-14","age":"","mstatus":"","insh":"K44007814","cliId":"","pno":"7852212308","cno":"","email":"mike.killion51@outlook.com","ename":"","eno":"","pphy":"PATRICIA KLASSEN","ppno":"7852955310","pcpadd":"600 SW JEWELL AVE","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1607","pcpcounty":"","pcpid":"","pcpname":"TOPEKA PHYSICIAN GROUP LLC","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5300 NW Hoch Rd","madd2":"","madd3":"","mcity":"Silver Lake","mstate":"KS","mzip":"66539","pcpfaxno":"7853792457","pcpnpi":"1073522868","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44007814","medicareid":"3T17P65EX38","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":["Z9481","D696","Z9189","Z2989","G629","M7989","I10","M25551","Z7689","R001","I4510","I493","G4733","C9001","Z79899","Z87891","I444","R9431","Z08","D485","L820","D044","E785","Z125","C4442","C9000","Z9289","M25511","M532X7","J069","M5450","L570","Z0131","R2689","C9002","Z23","L578","L814","L821","D1801","M5432","M5415","M9914","M4727","H5212","D0461","M160","D045","L905"],"date":["2026-05-04","2026-05-04","2026-05-04","2026-05-04","2026-05-04","2026-05-04","2026-05-04","2026-05-07","2026-05-18","2025-07-23","2025-07-23","2025-07-23","2025-07-23","2026-05-18","2025-07-23","2025-07-23","2025-07-23","2025-07-23","2026-04-13","2026-04-13","2025-08-11","2025-08-19","2025-10-09","2025-10-09","2026-04-10","2026-04-10","2025-10-20","2025-11-06","2025-12-09","2025-09-22","2026-04-21","2026-06-04","2025-03-31","2025-04-07","2026-05-04","2025-09-22","2026-01-05","2026-04-13","2026-04-13","2026-01-05","2026-05-04","2026-04-21","2026-04-21","2026-02-27","2026-03-16","2026-04-13","2026-05-07","2026-06-04","2026-06-04"],"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":[["","","PANTOPRAZOLE SODIUM","20 MG","","Select","Select",""],["","","ACYCLOVIR","800 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","METHYLPREDNISOLONE DOSE PACK","4 MG","","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":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"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":""}]}]}