Summary Table
Categories |
Total Count |
PII |
0 |
URL |
0 |
DNS |
0 |
EKL |
0 |
IP |
0 |
PORT |
0 |
VsID |
0 |
CF |
0 |
AI |
0 |
VPD |
0 |
PL |
0 |
Other |
0 |
File Content
<div class="accordion ewv" [ngClass]="{'split': isSplitView}">
<!-- Accordion Trigger -->
<input id={{accordionId}} type="checkbox" [(ngModel)]="collapseState" role="button" aria-label="Billing Information Section">
<label for={{accordionId}}>Billing Information</label>
<h5 *ngIf="claimType !== 'INSTITUTIONAL'" class="icon-function acc-adj">
<span>
<strong>POS: </strong>{{ data?.billingMiscellanous?.placeOfService }}
</span>
<div class="tooltip">
<ng-container *ngIf="isRightSide">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_billingInfo_1">
<strong>Frequency: </strong><span appHighlight [rightSideData]="data?.billingMiscellanous?.frequency" [leftSideData]="compareData?.billingMiscellanous?.frequency">{{
data?.billingMiscellanous?.frequency }}</span>
</a>
</ng-container>
<ng-container *ngIf="!isRightSide">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_billingInfo_2">
<strong>Frequency: </strong>{{ data?.billingMiscellanous?.frequency }}
</a>
</ng-container>
<span id="SPN_wildcard_billingInfo_1" role="tooltip">{{frequencyValues[data?.billingMiscellanous?.frequency]}}</span>
</div>
</h5>
<h5 *ngIf="claimType === 'INSTITUTIONAL'" class="icon-function acc-adj">
<div id="SPN_pos_billingInfo_1">
<div class="tooltip">
<ng-container *ngIf="!isRightSide">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_billingInfo_2">
<strong>TOB: </strong>{{ data?.billingMiscellanous?.typeOfBill }}/{{ data?.billingMiscellanous?.frequency }}
</a>
</ng-container>
<ng-container *ngIf="isRightSide">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_billingInfo_2">
<strong>TOB: </strong><span appHighlight [rightSideData]="data?.billingMiscellanous?.typeOfBill" [leftSideData]="compareData?.billingMiscellanous?.typeOfBill">{{
data?.billingMiscellanous?.typeOfBill }}</span>/
<span id="SPN_wildcard_billingInfo_2" role="tooltip" appHighlight [rightSideData]="data?.billingMiscellanous?.frequency"
[leftSideData]="compareData?.billingMiscellanous?.frequency">{{ data?.billingMiscellanous?.frequency
}}</span>
</a>
</ng-container>
<span>{{frequencyValues[data?.billingMiscellanous?.frequency]}}</span>
</div>
</div>
</h5>
<div class="accordion-content row">
<div *ngIf="data?.patientHeaderInfo?.claimType === 'INSTITUTIONAL'">
<table id="TBL_info_billingInfo_1" class="clean-table">
<thead>
<tr>
<th>
<label for="statementFromTo">Statement Covers Period</label>
</th>
<th>
<label for="admissionDate">Admission</label>
</th>
<th>
<label for="admissionHour">ADHR</label>
</th>
<th>
<label for="dischargeDateOrHour">DHR</label>
</th>
<th>
<label for="patientStatus">Stat</label>
</th>
<th>
<label for="admittingDiagnosis">Admit DX</label>
</th>
<th>
<label for="reasonForVisit">Reason</label>
</th>
</tr>
</thead>
<tbody>
<!-- <ng-container *ngFor="let row of [data?.billingMiscellanous]; let compareRow of [compareData?.billingMiscellanous]"> -->
<tr>
<!-- <td *ngFor="let column of instTableColumns"> -->
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.statementFromTo" [leftSideData]="compareData?.billingMiscellanous?.statementFromTo">{{data?.billingMiscellanous?.statementFromTo}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.statementFromTo}}</span>
</td>
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.admissionDate" [leftSideData]="compareData?.billingMiscellanous?.admissionDate">{{data?.billingMiscellanous?.admissionDate}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.admissionDate}}</span>
</td>
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.admissionHour" [leftSideData]="compareData?.billingMiscellanous?.admissionHour">{{data?.billingMiscellanous?.admissionHour}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.admissionHour}}</span>
</td>
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.dischargeDateOrHour" [leftSideData]="compareData?.billingMiscellanous?.dischargeDateOrHour">{{data?.billingMiscellanous?.dischargeDateOrHour}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.dischargeDateOrHour}}</span>
</td>
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.patientStatus" [leftSideData]="compareData?.billingMiscellanous?.patientStatus">{{data?.billingMiscellanous?.patientStatus}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.patientStatus}}</span>
</td>
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.admittingDiagnosis" [leftSideData]="compareData?.billingMiscellanous?.admittingDiagnosis">{{data?.billingMiscellanous?.admittingDiagnosis}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.admittingDiagnosis}}</span>
</td>
<td>
<span *ngIf="isRightSide" appHighlight [rightSideData]="data?.billingMiscellanous?.reasonForVisit" [leftSideData]="compareData?.billingMiscellanous?.reasonForVisit">{{data?.billingMiscellanous?.reasonForVisit}}</span>
<span *ngIf="!isRightSide">{{data?.billingMiscellanous?.reasonForVisit}}</span>
</td>
</tr>
<!-- </ng-container> -->
</tbody>
</table>
</div>
<div class="col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<!-- Diagnosis Codes -->
<div *ngIf="data?.dx.length > 0" class="x-row">
<div class="x-type">DX:</div>
<div class="x-codes">
<ng-container *ngIf="isRightSide">
<div *ngFor="let d of dx; let i = index">
<span>{{i + 1 }}:</span>
<span appHighlight [leftSideData]="compareData?.dx[i]" [rightSideData]="data?.dx[i]">{{ data?.dx[i] ? data?.dx[i]:
'\u2013\u2013\u2013' }}</span>
</div>
</ng-container>
<ng-container *ngIf="!isRightSide">
<div *ngFor="let d of data?.dx; let i = index">
<span>{{i + 1 }}:</span>
<span>{{ d }}</span>
</div>
</ng-container>
</div>
</div>
<!-- External Codes -->
<div *ngIf="data?.eCodes.length > 0" class="x-row">
<div class="x-type">E:</div>
<div class="x-codes">
<ng-container *ngIf="isRightSide">
<div *ngFor="let e of eCodes; index as i">
<span>{{i + 1 }}:</span>
<span appHighlight [leftSideData]="compareData?.eCodes[i]" [rightSideData]="data?.eCodes[i]">{{ data?.eCodes[i]?
data?.eCodes[i]: '\u2013\u2013\u2013' }}</span>
</div>
</ng-container>
<ng-container *ngIf="!isRightSide">
<div *ngFor="let e of data?.eCodes; index as i">
<span>{{i + 1 }}:</span>
<span>{{ e }}</span>
</div>
</ng-container>
</div>
</div>
<!-- Procedure Codes -->
<div *ngIf="viewType==='quick'">
<div *ngIf="data?.px.length > 0" class="x-row">
<div class="x-type">PX:</div>
<div class="x-codes">
<ng-container *ngIf="isRightSide">
<div *ngFor="let p of px; index as i">
<span>{{i + 1 }}:</span>
<span appHighlight [leftSideData]="compareData?.px[i]" [rightSideData]="data?.px[i]">{{ data?.px[i]? data?.px[i]:
'\u2013\u2013\u2013' }}</span>
</div>
</ng-container>
<ng-container *ngIf="!isRightSide">
<div *ngFor="let p of data?.px; index as i">
<span>{{i + 1 }}:</span>
<span>{{ p }}</span>
</div>
</ng-container>
</div>
</div>
</div>
<!-- Service Lines Table -->
<div *ngIf="viewType==='quick'" class="col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div class="row"></div>
<h5>Service Lines</h5>
<div class="fixed">
<table id="TBL_serviceLines_billingInfo_1" class="clean-table">
<thead>
<tr>
<th *ngFor="let column of serviceLinesTableColumns">
<label for="{{column['title']}}">{{column['title']}}</label>
</th>
</tr>
</thead>
<tbody>
<ng-container *ngFor="let row of data?.serviceLinesInfo; let i = index">
<tr>
<ng-container *ngIf="isRightSide">
<td *ngFor="let column of serviceLinesTableColumns">
<ng-container *ngIf="compareData?.serviceLinesInfo[i]">
<!-- <span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i][column['property']]"
[rightSideData]="row[column['property']]"> -->
<ng-container *ngIf="column['property'] === 'pos'">
<ng-container *ngIf="row[column['property']]">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i][column['property']]" [rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<ng-container *ngIf="!row[column['property']] && data?.billingMiscellanous?.placeOfService">
<span appHighlight [leftSideData]="compareData?.billingMiscellanous?.placeOfService" [rightSideData]="data?.billingMiscellanous?.placeOfService">
{{data?.billingMiscellanous?.placeOfService}}
</span>
</ng-container>
</ng-container>
<ng-container *ngIf="column['property'] === 'charge'">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i][column['property']]" [rightSideData]="row[column['property']]">
{{row[column['property']] ? '$'+row[column['property']] : ''}}
</span>
</ng-container>
<ng-container *ngIf="column['property'] !== 'charge' && column['property'] !== 'pos'">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i][column['property']]" [rightSideData]="row[column['property']]">
{{row[column['property']] ? row[column['property']] : ''}}
</span>
</ng-container>
</ng-container>
<ng-container *ngIf="!compareData?.serviceLinesInfo[i]">
<span appHighlight [leftSideData]="''" [rightSideData]="row[column['property']]">
<ng-container *ngIf="column['property'] === 'pos'">
{{row[column['property']] ? row[column['property']] : data?.billingMiscellanous?.placeOfService}}
</ng-container>
<ng-container *ngIf="column['property'] !== 'pos'">
{{row[column['property']] ? row[column['property']] : ''}}
</ng-container>
</span>
</ng-container>
</td>
</ng-container>
<ng-container *ngIf="!isRightSide">
<td *ngFor="let column of serviceLinesTableColumns">
<ng-container *ngIf="column['property'] === 'charge'">
{{'$'+row[column['property']]}}
</ng-container>
<ng-container *ngIf="column['property'] === 'pos'">
{{row[column['property']] ? row[column['property']] : data?.billingMiscellanous?.placeOfService}}
</ng-container>
<ng-container *ngIf="column['property'] !== 'charge' && column['property'] !== 'pos'">
{{row[column['property']] }}
</ng-container>
</td>
</ng-container>
</tr>
<ng-container *ngIf="(claimType==='PROFESSIONAL' || claimType==='INSTITUTIONAL')">
<tr *ngFor="let drugLineRow of row?.listOfDrugLines; index as j" class="secondary-service-lines">
<td></td>
<td *ngIf="claimType==='PROFESSIONAL'" colspan="4">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugCategory_5010" [rightSideData]="drugLineRow?.drugCategory_5010">
<strong>Drug RX ({{drugLineRow?.drugCategory_5010}}):</strong>
</span>
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRx" [rightSideData]="drugLineRow?.drugRx">{{drugLineRow?.drugRx}}</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span><strong>Drug RX ({{drugLineRow?.drugCategory_5010}}):</strong></span> <span>{{drugLineRow?.drugRx}}</span>
</ng-container>
</td>
<td *ngIf="claimType==='INSTITUTIONAL'" colspan="3">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugCategory_5010" [rightSideData]="drugLineRow?.drugCategory_5010">
<strong>Drug RX ({{drugLineRow?.drugCategory_5010}}):</strong></span>
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRx" [rightSideData]="drugLineRow?.drugRx">{{drugLineRow?.drugRx}}</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span><strong>Drug RX ({{drugLineRow.drugCategory_5010}}):</strong></span> <span>{{drugLineRow?.drugRx}}</span>
</ng-container>
</td>
<td *ngIf="claimType==='PROFESSIONAL'" colspan="2">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRxNdcCode" [rightSideData]="drugLineRow?.drugRxNdcCode">
{{drugLineRow?.drugRxNdcCode}}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>{{drugLineRow?.drugRxNdcCode}}</span>
</ng-container>
</td>
<td *ngIf="claimType==='INSTITUTIONAL'" colspan="2">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRxNdcCode" [rightSideData]="drugLineRow?.drugRxNdcCode">
{{drugLineRow?.drugRxNdcCode}}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>{{drugLineRow?.drugRxNdcCode}}</span>
</ng-container>
</td>
<td *ngIf="claimType==='PROFESSIONAL'">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRxQuantityPlusType" [rightSideData]="drugLineRow.drugRxQuantityPlusType">
{{drugLineRow?.drugRxQuantityPlusType}}</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>{{drugLineRow?.drugRxQuantityPlusType}}</span>
</ng-container>
</td>
<td *ngIf="claimType==='INSTITUTIONAL'">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRxQuantity" [rightSideData]="drugLineRow.drugRxQuantity">
{{drugLineRow?.drugRxQuantity}}</span> / <span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRxType" [rightSideData]="drugLineRow.drugRxType">{{drugLineRow.drugRxType}}</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>{{drugLineRow?.drugRxQuantity}}</span> / <span>{{drugLineRow.drugRxType}}</span>
</ng-container>
</td>
<!-- <td *ngIf="claimType==='INSTITUTIONAL'">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.drugRxType" [rightSideData]="drugLineRow.drugRxType">{{drugLineRow.drugRxType}}</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>{{drugLineRow?.drugRxType}}</span>
</ng-container>
</td> -->
<td *ngIf="claimType==='PROFESSIONAL' || claimType==='INSTITUTIONAL'">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfDrugLines[j]?.amount" [rightSideData]="drugLineRow.amount">
{{drugLineRow?.amount | currency}}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>{{drugLineRow?.amount | currency}}</span>
</ng-container>
</td>
</tr>
</ng-container>
<ng-container *ngIf="claimType === 'PROFESSIONAL' || claimType === 'INSTITUTIONAL'">
<tr *ngFor="let providerInfo of row?.listOfProviderInfo; index as k" class="secondary-service-lines">
<td></td>
<!-- compareData?.serviceLinesInfo[i]?.listOfDrugLines[j] -->
<td colspan="2">
<ng-container *ngIf="isRightSide">
<strong>Rendering Physician Name:</strong>
<!-- ::!!{{compareData?.serviceLinesInfo[i]?.listOfProviderInfo[k]?.name}} -->
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfProviderInfo[k]?.name" [rightSideData]="providerInfo?.name">
{{ providerInfo?.name }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
<strong>Rendering Physician Name:</strong> {{ providerInfo?.name }}
</span>
</ng-container>
</td>
<td colspan="2">
<ng-container *ngIf="isRightSide">
<strong>NPI:</strong>
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfProviderInfo[k]?.providerNpi_5010" [rightSideData]="providerInfo?.providerNpi_5010">
{{ providerInfo?.providerNpi_5010 }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
<strong>NPI:</strong> {{ providerInfo?.providerNpi_5010 }}
</span>
</ng-container>
</td>
<td colspan="3">
<ng-container *ngIf="isRightSide">
<strong>Taxonomy Code:</strong>
<span appHighlight [leftSideData]="compareData?.serviceLinesInfo[i]?.listOfProviderInfo[k]?.taxonomyCode" [rightSideData]="providerInfo?.taxonomyCode">
{{ providerInfo?.taxonomyCode }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
<strong>Taxonomy Code:</strong> {{ providerInfo?.taxonomyCode }}
</span>
</ng-container>
</td>
<td *ngIf="claimType === 'PROFESSIONAL'"></td>
</tr>
</ng-container>
</ng-container>
</tbody>
</table>
</div>
<ng-container *ngIf="isRightSide">
<div *ngIf="data?.serviceLinesInfo.length>0" class="sum-line">
<span appHighlight [leftSideData]="compareData?.billingMiscellanous.totalClaimCharges" [rightSideData]="data?.billingMiscellanous?.totalClaimCharges">
Total Charges: ${{ data?.billingMiscellanous.totalClaimCharges }}
</span>
</div>
</ng-container>
<ng-container *ngIf="!isRightSide">
<div *ngIf="data?.serviceLinesInfo.length>0" class="sum-line">Total Charges: ${{ data?.billingMiscellanous?.totalClaimCharges
}}</div>
</ng-container>
</div>
<!-- End of Service Lines Table -->
</div>
</div>
<div class="bottom-bar" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}"></div>
</div>