{
    "section": "plan",
    "templateSet": "Venous insufficiency",
    "templates": [
        {
            "text": "Labs",
            "template": "{children}",
            "children": [
                {
                    "text": "Serum labs",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "CBC w\/ auto diff",
                            "template": "CBC w\/ auto diff"
                        },
                        {
                            "text": "Creatinine kinase (CK), serum",
                            "template": "Creatinine kinase (CK), serum"
                        },
                        {
                            "text": "Troponin T, serum",
                            "template": "Troponin T, serum"
                        },
                        {
                            "text": "B-type natriuretic peptide (BNP), serum",
                            "template": "B-type natriuretic peptide (BNP), serum"
                        },
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "Hepatic function panel (LFTs)",
                            "template": "Hepatic function panel (LFTs)"
                        },
                        {
                            "text": "Albumin, serum",
                            "template": "Albumin, serum"
                        },
                        {
                            "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": "PT (prothrombin time)",
                            "template": "PT (prothrombin time)"
                        },
                        {
                            "text": "D-dimer, plasma",
                            "template": "D-dimer, plasma"
                        },
                        {
                            "text": "Heparin anti-factor Xa",
                            "template": "Heparin anti-factor Xa"
                        },
                        {
                            "text": "Fondaparinux anti-factor Xa",
                            "template": "Fondaparinux anti-factor Xa"
                        },
                        {
                            "text": "Erythrocyte sedimentation rate (ESR)",
                            "template": "Erythrocyte sedimentation rate (ESR)"
                        },
                        {
                            "text": "Glucose, fingerstick",
                            "template": "Glucose, fingerstick"
                        },
                        {
                            "text": "Hemoglobin A1c (HbA1c), blood",
                            "template": "Hemoglobin A1c (HbA1c), blood"
                        },
                        {
                            "text": "Lipid panel",
                            "template": "Lipid panel"
                        },
                        {
                            "text": "TSH (thyroid-stimulating hormone), serum",
                            "template": "TSH (thyroid-stimulating hormone), serum"
                        },
                        {
                            "text": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        }
                    ]
                },
                {
                    "text": "Urine labs",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Culture, urine, bacterial",
                            "template": "Culture, urine, bacterial"
                        },
                        {
                            "text": "Urinalysis, complete (with micro)",
                            "template": "Urinalysis, complete (with micro)"
                        },
                        {
                            "text": "Urine dipstick for protein",
                            "template": "Urine dipstick for protein"
                        },
                        {
                            "text": "Protein, 24-hour urine",
                            "template": "Protein, 24-hour urine"
                        },
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Imaging",
            "template": "{children}",
            "children": [
                {
                    "text": "Imaging",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray chest, PA and lateral",
                            "template": "X-ray chest, PA and lateral"
                        },
                        {
                            "text": "Echocardiogram",
                            "template": "Echocardiogram"
                        },
                        {
                            "text": "US",
                            "template": "US"
                        },
                        {
                            "text": "CT abdomen and pelvis w\/ contrast",
                            "template": "CT abdomen and pelvis w\/ contrast"
                        },
                        {
                            "text": "CT abdomen and pelvis w\/o contrast",
                            "template": "CT abdomen and pelvis w\/o contrast"
                        },
                        {
                            "text": "Angiography lower extremity veins bilateral",
                            "template": "Angiography lower extremity veins bilateral"
                        },
                        {
                            "text": "Angiography lower extremity veins right",
                            "template": "Angiography lower extremity veins right"
                        },
                        {
                            "text": "Angiography lower extremity veins left",
                            "template": "Angiography lower extremity veins left"
                        },
                        {
                            "text": "MRV lower extremities, bilateral",
                            "template": "MRV lower extremities, bilateral"
                        },
                        {
                            "text": "MRV lower extremity, right",
                            "template": "MRV lower extremity, right"
                        },
                        {
                            "text": "MRV lower extremity, left",
                            "template": "MRV lower extremity, left"
                        },
                        {
                            "text": "CTA lower extremity veins, bilateral",
                            "template": "CTA lower extremity veins, bilateral"
                        },
                        {
                            "text": "CTA lower extremity veins, right",
                            "template": "CTA lower extremity veins, right"
                        },
                        {
                            "text": "CTA lower extremity veins, left",
                            "template": "CTA lower extremity veins, left"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "EKG, 12-lead",
                            "template": "EKG, 12-lead"
                        },
                        {
                            "text": "Exercise treadmill test",
                            "template": "Exercise treadmill test"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Blood viscosity lowering agent",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "pentoxifylline 400 mg ER tab",
                            "template": "pentoxifylline 400 mg ER tab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Supplies, Equipment",
            "template": "{children}",
            "children": [
                {
                    "text": "Compression stockings",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Pneumatic compression stockings",
                            "template": "Pneumatic compression stockings"
                        },
                        {
                            "text": "T.E.D. compression stockings (18 mm Hg)",
                            "template": "T.E.D. compression stockings (18 mm Hg)"
                        },
                        {
                            "text": "Jobst, fitted compression stockings (20-40 mm Hg)",
                            "template": "Jobst, fitted compression stockings (20-40 mm Hg)"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Patient instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Elevate affected area to minimize edema",
                            "template": "Elevate affected area to minimize edema"
                        },
                        {
                            "text": "Wear T.E.D. compression stockings as instructed",
                            "template": "Wear T.E.D. compression stockings as instructed"
                        },
                        {
                            "text": "Wear pneumatic compression stockings as instructed",
                            "template": "Wear pneumatic compression stockings as instructed"
                        },
                        {
                            "text": "Wear Jobst, fitted compression stockings as instructed",
                            "template": "Wear Jobst, fitted compression stockings as instructed"
                        },
                        {
                            "text": "Compression stocking instructions given",
                            "template": "Compression stocking instructions given"
                        }
                    ]
                }
            ]
        },
        {
            "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 24 hours",
                            "template": "Return visit in 24 hours"
                        },
                        {
                            "text": "Return visit in 48 hours",
                            "template": "Return visit in 48 hours"
                        },
                        {
                            "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": "Admit to ER\/inpatient care",
                    "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": "Refer to Cardiology",
                            "template": "Refer to Cardiology"
                        },
                        {
                            "text": "Refer to Vascular Surgery",
                            "template": "Refer to Vascular Surgery"
                        },
                        {
                            "text": "Refer to smoking cessation program",
                            "template": "Refer to smoking cessation program"
                        }
                    ]
                }
            ]
        }
    ]
}