{
    "section": "plan",
    "templateSet": "Hypothyroidism",
    "templates": [
        {
            "text": "Labs",
            "template": "{children}",
            "children": [
                {
                    "text": "Labs",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "TSH (thyroid-stimulating hormone), serum",
                            "template": "TSH (thyroid-stimulating hormone), serum"
                        },
                        {
                            "text": "Thyroxine (T4), free, serum",
                            "template": "Thyroxine (T4), free, serum"
                        },
                        {
                            "text": "T3 (triiodothyronine), total, serum",
                            "template": "T3 (triiodothyronine), total, serum"
                        },
                        {
                            "text": "Thyroid peroxidase (TPO) antibody, serum",
                            "template": "Thyroid peroxidase (TPO) antibody, serum"
                        },
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "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": "Hepatic function panel (LFTs)",
                            "template": "Hepatic function panel (LFTs)"
                        },
                        {
                            "text": "Lipid panel",
                            "template": "Lipid panel"
                        },
                        {
                            "text": "Creatinine kinase (CK), serum",
                            "template": "Creatinine kinase (CK), serum"
                        },
                        {
                            "text": "Troponin T, serum",
                            "template": "Troponin T, serum"
                        },
                        {
                            "text": "Lactate dehydrogenase (LDH), serum",
                            "template": "Lactate dehydrogenase (LDH), serum"
                        },
                        {
                            "text": "Prolactin, serum",
                            "template": "Prolactin, serum"
                        },
                        {
                            "text": "Cortisol, free, serum",
                            "template": "Cortisol, free, serum"
                        },
                        {
                            "text": "Cortisol, free, urine",
                            "template": "Cortisol, free, urine"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "text": "Glucose, fasting, plasma",
                            "template": "Glucose, fasting, plasma"
                        },
                        {
                            "text": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        },
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        },
                        {
                            "text": "Urinalysis, complete (with micro)",
                            "template": "Urinalysis, complete (with micro)"
                        },
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Imaging",
            "template": "{children}",
            "children": [
                {
                    "text": "Imaging",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Radioactive iodine uptake study",
                            "template": "Radioactive iodine uptake study"
                        },
                        {
                            "text": "X-ray chest, PA and lateral",
                            "template": "X-ray chest, PA and lateral"
                        },
                        {
                            "text": "Echocardiogram",
                            "template": "Echocardiogram"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "EKG, 12-lead",
                            "template": "EKG, 12-lead"
                        },
                        {
                            "text": "TRH stimulation test",
                            "template": "TRH stimulation test"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Thyroid replacement therapy",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "levothyroxine 25 mcg tab",
                            "template": "levothyroxine 25 mcg tab"
                        },
                        {
                            "text": "levothyroxine 25 mcg tab",
                            "template": "levothyroxine 25 mcg tab"
                        },
                        {
                            "text": "levothyroxine 50 mcg tab",
                            "template": "levothyroxine 50 mcg tab"
                        },
                        {
                            "text": "levothyroxine 100 mcg tab",
                            "template": "levothyroxine 100 mcg tab"
                        },
                        {
                            "text": "liothyronine 25 mcg tab",
                            "template": "liothyronine 25 mcg tab"
                        },
                        {
                            "text": "Armour Thyroid 0.5 grain tab",
                            "template": "Armour Thyroid 0.5 grain tab"
                        },
                        {
                            "text": "Armour Thyroid 1 grain tab",
                            "template": "Armour Thyroid 1 grain tab"
                        },
                        {
                            "text": "Levothroid 25 mcg tab",
                            "template": "Levothroid 25 mcg tab"
                        },
                        {
                            "text": "Levothroid 25 mcg tab",
                            "template": "Levothroid 25 mcg tab"
                        },
                        {
                            "text": "Levothroid 50 mcg tab",
                            "template": "Levothroid 50 mcg tab"
                        },
                        {
                            "text": "Levothroid 100 mcg tab",
                            "template": "Levothroid 100 mcg tab"
                        },
                        {
                            "text": "Levoxyl 25 mcg tab",
                            "template": "Levoxyl 25 mcg tab"
                        },
                        {
                            "text": "Levoxyl 25 mcg tab",
                            "template": "Levoxyl 25 mcg tab"
                        },
                        {
                            "text": "Levoxyl 50 mcg tab",
                            "template": "Levoxyl 50 mcg tab"
                        },
                        {
                            "text": "Levoxyl 100 mcg tab",
                            "template": "Levoxyl 100 mcg tab"
                        },
                        {
                            "text": "Synthroid 25 mcg tab",
                            "template": "Synthroid 25 mcg tab"
                        },
                        {
                            "text": "Synthroid 25 mcg tab",
                            "template": "Synthroid 25 mcg tab"
                        },
                        {
                            "text": "Synthroid 50 mcg tab",
                            "template": "Synthroid 50 mcg tab"
                        },
                        {
                            "text": "Synthroid 100 mcg tab",
                            "template": "Synthroid 100 mcg tab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Patient provided with the following instructions:",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Follow high fiber diet to reduce risk of constipation",
                            "template": "Follow high fiber diet to reduce risk of constipation"
                        },
                        {
                            "text": "Follow low-fat, low-calorie diet to promote healthy weight",
                            "template": "Follow low-fat, low-calorie diet to promote healthy weight"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up, Referrals",
            "template": "{children}",
            "children": [
                {
                    "text": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 1 week",
                            "template": "Return visit in 1 week"
                        },
                        {
                            "text": "Return visit in 2 weeks",
                            "template": "Return visit in 2 weeks"
                        },
                        {
                            "text": "Return visit in 1 month",
                            "template": "Return visit in 1 month"
                        },
                        {
                            "text": "Return visit in 2 months",
                            "template": "Return visit in 2 months"
                        },
                        {
                            "text": "Return visit in 3 months",
                            "template": "Return visit in 3 months"
                        },
                        {
                            "text": "Return visit in 6 months",
                            "template": "Return visit in 6 months"
                        },
                        {
                            "text": "Return visit in 1 year",
                            "template": "Return visit in 1 year"
                        }
                    ]
                },
                {
                    "text": "Return for f\/u labs to monitor clinical response, check TSH level",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit in 6 weeks",
                            "template": "Return visit in 6 weeks"
                        },
                        {
                            "text": "Return visit in 8 weeks",
                            "template": "Return visit in 8 weeks"
                        },
                        {
                            "text": "Return visit in 12 weeks",
                            "template": "Return visit in 12 weeks"
                        },
                        {
                            "text": "Return visit in 1 year",
                            "template": "Return visit in 1 year"
                        }
                    ]
                },
                {
                    "text": "Return for lab monitoring of subclinical hypothyroidism",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visits as needed",
                            "template": "Return visits as needed"
                        },
                        {
                            "text": "Return visit in 1 year",
                            "template": "Return visit in 1 year"
                        },
                        {
                            "text": "Return visit in 3 years",
                            "template": "Return visit in 3 years"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Endocrinology",
                            "template": "Refer to Endocrinology"
                        }
                    ]
                }
            ]
        }
    ]
}