{
    "section": "plan",
    "templateSet": "Weight loss, unintended",
    "templates": [
        {
            "text": "Labs",
            "template": "{children}",
            "children": [
                {
                    "text": "Blood tests (except HIV)",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC w\/ auto diff",
                            "template": "CBC w\/ auto diff"
                        },
                        {
                            "text": "Metabolic panel, basic (BMP), serum",
                            "template": "Metabolic panel, basic (BMP), serum"
                        },
                        {
                            "text": "Metabolic panel, comprehensive (CMP), serum",
                            "template": "Metabolic panel, comprehensive (CMP), serum"
                        },
                        {
                            "text": "Total protein",
                            "template": "Total protein"
                        },
                        {
                            "text": "Hepatic function panel (LFTs)",
                            "template": "Hepatic function panel (LFTs)"
                        },
                        {
                            "text": "Hepatitis B panel",
                            "template": "Hepatitis B panel"
                        },
                        {
                            "text": "TSH (thyroid-stimulating hormone), serum",
                            "template": "TSH (thyroid-stimulating hormone), serum"
                        },
                        {
                            "text": "Thyroxine (T4), free, serum",
                            "template": "Thyroxine (T4), free, serum"
                        },
                        {
                            "text": "Lipase, serum",
                            "template": "Lipase, serum"
                        },
                        {
                            "text": "Amylase, serum",
                            "template": "Amylase, serum"
                        },
                        {
                            "text": "Erythrocyte sedimentation rate (ESR)",
                            "template": "Erythrocyte sedimentation rate (ESR)"
                        },
                        {
                            "text": "C-reactive protein (CRP), serum",
                            "template": "C-reactive protein (CRP), serum"
                        },
                        {
                            "text": "CMV",
                            "template": "CMV"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "text": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        },
                        {
                            "text": "Ferritin, serum",
                            "template": "Ferritin, serum"
                        },
                        {
                            "text": "Folate, serum",
                            "template": "Folate, serum"
                        },
                        {
                            "text": "Vitamin B12, serum",
                            "template": "Vitamin B12, serum"
                        },
                        {
                            "text": "Methylmalonic acid, serum",
                            "template": "Methylmalonic acid, serum"
                        },
                        {
                            "text": "Vitamin D, 25-OH, serum",
                            "template": "Vitamin D, 25-OH, serum"
                        },
                        {
                            "text": "Tissue transglutaminase (tTG) antibody, IgA, serum",
                            "template": "Tissue transglutaminase (tTG) antibody, IgA, serum"
                        }
                    ]
                },
                {
                    "text": "Blood glucose, finger stick",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Glucose, fingerstick",
                            "template": "Glucose, fingerstick"
                        }
                    ]
                },
                {
                    "text": "HIV tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "HIV-1+HIV-2 antibody screen, rapid test",
                            "template": "HIV-1+HIV-2 antibody screen, rapid test"
                        },
                        {
                            "text": "HIV-1+HIV-2 antibody screen, serum",
                            "template": "HIV-1+HIV-2 antibody screen, serum"
                        },
                        {
                            "text": "HIV-1 RNA quantification, PCR, plasma",
                            "template": "HIV-1 RNA quantification, PCR, plasma"
                        },
                        {
                            "text": "CD4 T-cell count, blood",
                            "template": "CD4 T-cell count, blood"
                        }
                    ]
                },
                {
                    "text": "TB tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "TST",
                            "template": "TST"
                        },
                        {
                            "text": "IGRA",
                            "template": "IGRA"
                        },
                        {
                            "text": "AFB smear and culture",
                            "template": "AFB smear and culture"
                        },
                        {
                            "text": "Culture, sputum",
                            "template": "Culture, sputum"
                        }
                    ]
                },
                {
                    "text": "Urine tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Urinalysis, routine (without micro)",
                            "template": "Urinalysis, routine (without micro)"
                        },
                        {
                            "text": "Urinalysis, complete (with micro)",
                            "template": "Urinalysis, complete (with micro)"
                        },
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        },
                        {
                            "text": "Urine toxicology",
                            "template": "Urine toxicology"
                        },
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        }
                    ]
                },
                {
                    "text": "Stool tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Fecal occult blood test (FOBT)",
                            "template": "Fecal occult blood test (FOBT)"
                        },
                        {
                            "text": "Ova and parasites, stool",
                            "template": "Ova and parasites, stool"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "GI procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Clinical swallowing study",
                            "template": "Clinical swallowing study"
                        },
                        {
                            "text": "Upper endoscopy",
                            "template": "Upper endoscopy"
                        },
                        {
                            "text": "Colonoscopy",
                            "template": "Colonoscopy"
                        },
                        {
                            "text": "Flexible sigmoidoscopy",
                            "template": "Flexible sigmoidoscopy"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Imaging",
            "template": "{children}",
            "children": [
                {
                    "text": "Plain films",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray chest, PA and lateral",
                            "template": "X-ray chest, PA and lateral"
                        },
                        {
                            "text": "Mammogram, diagnostic",
                            "template": "Mammogram, diagnostic"
                        },
                        {
                            "text": "Mammogram, screening",
                            "template": "Mammogram, screening"
                        }
                    ]
                },
                {
                    "text": "Ultrasound",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "US abdomen RUQ",
                            "template": "US abdomen RUQ"
                        },
                        {
                            "text": "US pelvis",
                            "template": "US pelvis"
                        }
                    ]
                },
                {
                    "text": "CT",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CT chest w\/ contrast",
                            "template": "CT chest w\/ contrast"
                        },
                        {
                            "text": "CT abdomen and pelvis w\/ contrast",
                            "template": "CT abdomen and pelvis w\/ contrast"
                        }
                    ]
                },
                {
                    "text": "GI studies",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Barium swallow (esophagram)",
                            "template": "Barium swallow (esophagram)"
                        },
                        {
                            "text": "Upper GI series",
                            "template": "Upper GI series"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Appetite stimulants, adults",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Megace ES 625 mg per 5 mL suspension",
                            "template": "Megace ES 625 mg per 5 mL suspension"
                        },
                        {
                            "text": "megestrol 40 mg per mL suspension",
                            "template": "megestrol 40 mg per mL suspension"
                        },
                        {
                            "text": "megestrol 40 mg per mL suspension",
                            "template": "megestrol 40 mg per mL suspension"
                        },
                        {
                            "text": "dronabinol 2.5 mg cap",
                            "template": "dronabinol 2.5 mg cap"
                        },
                        {
                            "text": "dronabinol 5 mg cap",
                            "template": "dronabinol 5 mg cap"
                        },
                        {
                            "text": "dronabinol 10 mg cap",
                            "template": "dronabinol 10 mg cap"
                        }
                    ]
                },
                {
                    "text": "Appetite stimulants, children",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "megestrol 40 mg per mL suspension",
                            "template": "megestrol 40 mg per mL suspension"
                        },
                        {
                            "text": "megestrol 20 mg tab",
                            "template": "megestrol 20 mg tab"
                        },
                        {
                            "text": "megestrol 40 mg tab",
                            "template": "megestrol 40 mg tab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Home care",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Eat small, frequent meals",
                            "template": "Eat small, frequent meals"
                        },
                        {
                            "text": "Consume calorie-dense foods",
                            "template": "Consume calorie-dense foods"
                        },
                        {
                            "text": "Consume high-calorie drinks or puddings between meals",
                            "template": "Consume high-calorie drinks or puddings between meals"
                        },
                        {
                            "text": "Take nutritional supplements between meals (Glucerna, Ensure, PediaSure, BOOST)\n                            ",
                            "template": "Take nutritional supplements between meals (Glucerna, Ensure, PediaSure, BOOST)\n                            "
                        },
                        {
                            "text": "Limit fluids during meals",
                            "template": "Limit fluids during meals"
                        },
                        {
                            "text": "Take vitamins",
                            "template": "Take vitamins"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up, Referrals",
            "template": "{children}",
            "children": [
                {
                    "text": "Return visit",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Phone follow-up as needed",
                            "template": "Phone follow-up as needed"
                        },
                        {
                            "text": "Return visit in 3-5 days",
                            "template": "Return visit in 3-5 days"
                        },
                        {
                            "text": "Return visit in 5-7 days",
                            "template": "Return visit in 5-7 days"
                        },
                        {
                            "text": "Return visit in 7-10 days",
                            "template": "Return visit in 7-10 days"
                        },
                        {
                            "text": "Return visit in 2 weeks",
                            "template": "Return visit in 2 weeks"
                        },
                        {
                            "text": "Return visit in 3 weeks",
                            "template": "Return visit in 3 weeks"
                        },
                        {
                            "text": "Return visit in 4 weeks",
                            "template": "Return visit in 4 weeks"
                        },
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 6 months",
                            "template": "Return visit in 6 months"
                        }
                    ]
                },
                {
                    "text": "Admit to ER\/hospital",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Admit to ER",
                            "template": "Admit to ER"
                        },
                        {
                            "text": "Admit to hospital",
                            "template": "Admit to hospital"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Referral to Endocrinology",
                            "template": "Referral to Endocrinology"
                        },
                        {
                            "text": "Refer to GI",
                            "template": "Refer to GI"
                        },
                        {
                            "text": "Refer to Psychiatry",
                            "template": "Refer to Psychiatry"
                        },
                        {
                            "text": "Refer to Psychology",
                            "template": "Refer to Psychology"
                        },
                        {
                            "text": "Refer to dietician",
                            "template": "Refer to dietician"
                        },
                        {
                            "text": "Refer to Geriatrics",
                            "template": "Refer to Geriatrics"
                        },
                        {
                            "text": "Refer to Hematology\/Oncology",
                            "template": "Refer to Hematology\/Oncology"
                        },
                        {
                            "text": "Refer to Physical Therapy",
                            "template": "Refer to Physical Therapy"
                        },
                        {
                            "text": "Refer to Social Services",
                            "template": "Refer to Social Services"
                        }
                    ]
                }
            ]
        }
    ]
}