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}">
<input id="{{accordionId}}" type="checkbox" [(ngModel)]="collapseState" role="button" aria-label="O H I Claim Adjustments Section">
<label for="{{accordionId}}">OHI Claim Adjustments</label>
<div class="accordion-content row" role="region">
<app-messages [ewvNoInfo]="!primaryOhiInfo && !secondaryOhiInfo && !tertiaryOhiInfo" [ewvMsg]="ohiClaimMsg"></app-messages>
<!-- Primary OHI Payer -->
<div class="row"></div>
<div *ngIf="primaryOhiInfo">
<div class="info-table">
<div class="row col one">
<!-- Primary -->
<table id="TBL_primaryOhiInfo_ohiClaimAdjustments_1" class="wide-header">
<tbody>
<tr>
<th id="TH_primaryOhiInfo_ohiPayerId_ohiClaimAdjustments_1">
<h5>Primary Payer ID:</h5>
</th>
<td id="TD_primaryOhiInfo_ohiPayerId_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID" [rightSideData]="primaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID">
{{ primaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_primaryOhiInfo_paymentSequenceIndicator_ohiClaimAdjustments_1">
Payment Seq. Indicator:
</th>
<td id="TD_primaryOhiInfo_paymentSequenceIndicator_ohiClaimAdjustments_1">P</td>
</tr>
<tr>
<th id="TH_primaryOhiInfo_fillingIndicator_ohiClaimAdjustments_1">
Filing Indicator:
</th>
<td id="TD_primaryOhiInfo_fillingIndicator_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.claimOhiHeaderBean?.filingIndicator" [rightSideData]="primaryOhiInfo?.claimOhiHeaderBean?.filingIndicator">
{{ primaryOhiInfo?.claimOhiHeaderBean?.filingIndicator }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.claimOhiHeaderBean?.filingIndicator }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_primaryOhiInfo_claimAdjustmentDate_ohiClaimAdjustments_1">
Claim Adjustment Date:
</th>
<td id="TD_primaryOhiInfo_claimAdjustmentDate_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate" [rightSideData]="primaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate">
{{ primaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="row col one no-flow">
<table id="TBL_primaryOhiInfo_ohiClaimAdjustments_2" class="wide-header">
<tbody>
<tr>
<th id="TH_primaryOhiInfo_ohiPayerName_ohiClaimAdjustments_1">
<h5>Other Payer Name:</h5>
</th>
<td id="TD_primaryOhiInfo_ohiPayerName_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.claimOhiHeaderBean?.otherPayerName" [rightSideData]="primaryOhiInfo?.claimOhiHeaderBean?.otherPayerName">
{{ primaryOhiInfo?.claimOhiHeaderBean?.otherPayerName }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.claimOhiHeaderBean?.otherPayerName }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_primaryOhiInfo_ohiGroupName_ohiClaimAdjustments_1">
OHI Group Name:
</th>
<td id="TD_primaryOhiInfo_ohiGroupName_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName" [rightSideData]="primaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName">
{{ primaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_primaryOhiInfo_insuranceType_ohiClaimAdjustments_1">
Insurance Type:
</th>
<td id="TD_primaryOhiInfo_insuranceType_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.claimOhiHeaderBean?.insuranceType" [rightSideData]="primaryOhiInfo?.claimOhiHeaderBean?.insuranceType">
{{ primaryOhiInfo?.claimOhiHeaderBean?.insuranceType }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.claimOhiHeaderBean?.insuranceType }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<!-- PRIMARY OHI Claim Adjustments sortable table component -->
<div *ngIf="primaryClaimAdjustmentsTableInfoRows.length > 0" class="row col two">
<!-- <app-table id="CMP_primaryOhiInfo_table_ohiClaimAdjustments_1" [columns]="primaryClaimAdjustmentsTableColumns" [loading]="loading"
[rows]="primaryClaimAdjustmentsTableInfoRows" [paginationSettings]="paginationSettings" [tableSettings]="tableSettings">
</app-table> -->
<table id="TBL_primaryOhiInfo_table_ohiClaimAdjustments_1" class="ewv-table">
<thead>
<tr>
<th class="clickable" *ngFor="let column of primaryClaimAdjustmentsTableColumns">
<label for="{{column['title']}}">{{column['title']}}</label>
</th>
</tr>
</thead>
<tbody>
<tr *ngFor="let row of primaryClaimAdjustmentsTableInfoRows; let i = index">
<td *ngFor="let column of primaryClaimAdjustmentsTableColumns">
<ng-container *ngIf="isRightSide">
<ng-container *ngIf="comparePrimaryClaimAdjustmentsTableInfoRows[i]">
<span *ngIf="column['property'] != 'adjustmentCode'" appHighlight [leftSideData]="comparePrimaryClaimAdjustmentsTableInfoRows[i][column['property']]"
[rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<ng-container *ngIf="!comparePrimaryClaimAdjustmentsTableInfoRows[i]">
<span *ngIf="column['property'] != 'adjustmentCode'" appHighlight [leftSideData]="''" [rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<span *ngIf="column['property'] === 'adjustmentCode'" class="tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_1">{{ row?.adjustmentCode }}</a>
<span id="SPN_wildcard_ohiClaims_1" role="tooltip">{{ row?.descriptionLong }}</span>
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span *ngIf="column['property'] != 'adjustmentCode'">{{row[column['property']]}}</span>
<span *ngIf="column['property'] === 'adjustmentCode'" class="tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_2">{{ row?.adjustmentCode }}</a>
<span id="SPN_wildcard_ohiClaims_2" role="tooltip">{{ row?.descriptionLong }}</span>
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- Medicare Inpatient Section -->
<div *ngIf="primaryOhiInfo?.showMedicareInPatient" class="col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<h5>Medicare Inpatient Adjudication</h5>
</div>
<div *ngIf="primaryOhiInfo?.showMedicareInPatient" class="info-table">
<div class="col one">
<table id="TBL_medInpatient_ohiClaimAdj_1" class="wide-header">
<tbody>
<tr>
<th>
Covered Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInpatientAdjudication?.coveredDays" [rightSideData]="primaryOhiInfo?.medicareInpatientAdjudication?.coveredDays">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Lifetime Reserve Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Lifetime Psych. Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim DRG Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim Disproportionate Share:
</th>
<td *ngIf="primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare"
[rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
MSP Pass-Thru Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim PPS Capital Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital FSP DRG:
</th>
<td *ngIf='primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital HSP DRG:
</th>
<td *ngIf='primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital DSH DRG:
</th>
<td *ngIf='primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="col one no-flow">
<table id="TBL_medInpatient_ohiClaimAdj_2" class="wide-header">
<tbody>
<tr>
<th>
PPS Oper. Fed. Spec. DRG Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount"
[rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Old Capital Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital IME Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Oper. Hosp. Spec. DRG Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount"
[rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital Outlier Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim Indirect Teaching Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount"
[rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Non-Payable Prof. Component:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent"
[rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital Exception Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Cost Report Day Count:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount" [rightSideData]="primaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount">
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- RARCs Table -->
<!-- Put conditionals in this DIV -->
<div *ngIf="primaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes" class="row col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div *ngIf="primaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes.length > 0" class="fix">
<div *ngFor="let r of primaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes; let i = index" class="rarc-code">
<div class="label" style="width: 183px;">Remit. Remark Code:</div>
<div class="code">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes[i]?.code"
[rightSideData]="r?.code">
{{ r?.code }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ r?.code }}
</span>
</ng-container>
</div>
<div [ngClass]="{'split': isSplitView}">
<div class="description tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_3">{{ r?.remarkLong }}</a>
<span id="SPN_wildcard_ohiClaims_3" role="tooltip">{{ r?.code }} : {{ r?.remarkLong }}</span>
</div>
</div>
<!-- <div class="code"> {{r.code}}</div>
<app-tooltip [data]='r' [type]='"remark"'></app-tooltip> -->
</div>
</div>
</div>
</div>
<!-- Medicare Outpatient Section -->
<div *ngIf="primaryOhiInfo?.showMedicareOutPatient" class="col three"
[ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div class="row" style="margin-bottom: 15px; border-bottom: 1px solid #ccc;"></div>
<h5 id="HDG_medicareOutpatientAdjudication_ohiClaimAdjustments_1">Medicare Outpatient Adjudication</h5>
</div>
<div *ngIf="primaryOhiInfo?.showMedicareOutPatient" class="info-table">
<div class="col one">
<table id="medicare-outpatient-table-small" class="wide-header">
<tbody>
<tr>
<th id="TH_reimbursementRate_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
Reimbursement Rate:
</th>
<td id="TD_reimbursementRate_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate" [rightSideData]="primaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate">
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_claimHcpcsPayAmt_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
Claim HCPCS Pay Amt:
</th>
<td id="TD_claimHcpcsPayAmt_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount" [rightSideData]="primaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount">
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="col one no-flow">
<table id="medicare-outpatient-table-small" class="wide-header">
<tbody>
<tr>
<th id="TH_esrdPaidAmount_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
ESRD Paid Amount:
</th>
<td id="TD_esrdPaidAmount_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount" [rightSideData]="primaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount">
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_nonPayableProf_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
Non-Payable Prof:
</th>
<td id="TD_nonPayableProf_medicareOutpatientAdjudication_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount"
[rightSideData]="primaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount">
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ primaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
primaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- RARCs Table -->
<!-- Put conditionals in this DIV -->
<div *ngIf="primaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes" class="row col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div *ngIf="primaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes.length > 0" class="fix">
<div *ngFor="let r of primaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes; let i = index" class="rarc-code">
<div class="label" style="width: 183px;">Remit. Remark Code:</div>
<div class="code">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="comparePrimaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes[i]?.code"
[rightSideData]="r?.code">
{{ r?.code }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ r?.code }}
</span>
</ng-container>
</div>
<div [ngClass]="{'split': isSplitView}">
<div class="description tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_4">{{ r?.remarkLong }}
</a>
<span id="SPN_wildcard_ohiClaims_4" role="tooltip">{{ r?.code }} : {{ r?.remarkLong }}</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- Secondary OHI Payer -->
<div *ngIf="secondaryOhiInfo">
<!-- OHI Section Break -->
<div *ngIf="primaryOhiInfo" class="row" style="margin-bottom: 15px; border-bottom: 3px solid #999;"></div>
<div class="info-table">
<div class="row col one">
<table id="TBL_secondaryOhiInfo_ohiClaimAdjustments_1" class="wide-header">
<tbody>
<tr>
<th id="TH_secondaryOhiInfo_ohiPayerId_ohiClaimAdjustments_1">
<h5>Secondary Payer ID:</h5>
</th>
<td id="TD_secondaryOhiInfo_ohiPayerId_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID" [rightSideData]="secondaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID">
{{ secondaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.claimOhiHeaderBean?.ohiPayerID }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_secondaryOhiInfo_paymentSequenceIndicator_ohiClaimAdjustments_1">
Payment Seq. Indicator:
</th>
<td id="TD_secondaryOhiInfo_paymentSequenceIndicator_ohiClaimAdjustments_1">S</td>
</tr>
<tr>
<th id="TH_secondaryOhiInfo_fillingIndicator_ohiClaimAdjustments_1">
Filing Indicator:
</th>
<td id="TD_secondaryOhiInfo_fillingIndicator_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.claimOhiHeaderBean?.filingIndicator" [rightSideData]="secondaryOhiInfo?.claimOhiHeaderBean?.filingIndicator">
{{ secondaryOhiInfo?.claimOhiHeaderBean?.filingIndicator }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.claimOhiHeaderBean?.filingIndicator }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_secondaryOhiInfo_claimAdjustmentDate_ohiClaimAdjustments_1">
Claim Adjustment Date:
</th>
<td id="TD_secondaryOhiInfo_claimAdjustmentDate_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate" [rightSideData]="secondaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate">
{{ secondaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="row col one no-flow">
<table id="TBL_secondaryOhiInfo_ohiClaimAdjustments_2" class="wide-header">
<tbody>
<tr>
<th id="TH_secondaryOhiInfo_ohiPayerName_ohiClaimAdjustments_1">
<h5>Other Payer Name:</h5>
</th>
<td id="TD_secondaryOhiInfo_ohiPayerName_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.claimOhiHeaderBean?.otherPayerName" [rightSideData]="secondaryOhiInfo?.claimOhiHeaderBean?.otherPayerName">
{{ secondaryOhiInfo?.claimOhiHeaderBean?.otherPayerName }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.claimOhiHeaderBean?.otherPayerName }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_secondaryOhiInfo_ohiGroupName_ohiClaimAdjustments_1">
OHI Group Name:
</th>
<td id="TD_secondaryOhiInfo_ohiGroupName_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName" [rightSideData]="secondaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName">
{{ secondaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_secondaryOhiInfo_insuranceType_ohiClaimAdjustments_1">
Insurance Type:
</th>
<td id="TD_secondaryOhiInfo_insuranceType_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.claimOhiHeaderBean?.insuranceType" [rightSideData]="secondaryOhiInfo?.claimOhiHeaderBean?.insuranceType">
{{ secondaryOhiInfo?.claimOhiHeaderBean?.insuranceType }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.claimOhiHeaderBean?.insuranceType }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<!-- -->
<div *ngIf="secondaryClaimAdjustmentsTableInfoRows.length > 0" class="row col two">
<!-- <app-table id="CMP_secondaryOhiInfo_table_ohiClaimAdjustments_1" [columns]="secondaryClaimAdjustmentsTableColumns" [loading]="loading"
[rows]="secondaryClaimAdjustmentsTableInfoRows" [paginationSettings]="paginationSettings" [tableSettings]="tableSettings">
</app-table> -->
<!-- TODO add highlighting to dynamic table -->
<table id="TBL_secondaryOhiInfo_table_ohiClaimAdjustments_1" class="ewv-table">
<thead>
<tr>
<th class="clickable" *ngFor="let column of secondaryClaimAdjustmentsTableColumns">
<label for="{{column['title']}}">{{column['title']}}</label>
</th>
</tr>
</thead>
<tbody>
<tr *ngFor="let row of secondaryClaimAdjustmentsTableInfoRows; let i = index">
<td *ngFor="let column of secondaryClaimAdjustmentsTableColumns">
<ng-container *ngIf="isRightSide">
<ng-container *ngIf="compareSecondaryClaimAdjustmentsTableInfoRows[i]">
<span *ngIf="column['property'] != 'adjustmentCode'" appHighlight [leftSideData]="compareSecondaryClaimAdjustmentsTableInfoRows[i][column['property']]"
[rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<ng-container *ngIf="!compareSecondaryClaimAdjustmentsTableInfoRows[i]">
<span *ngIf="column['property'] != 'adjustmentCode'" appHighlight [leftSideData]="''" [rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<span *ngIf="column['property'] === 'adjustmentCode'" class="tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_5">{{ row?.adjustmentCode }}</a>
<span id="SPN_wildcard_ohiClaims_5" role="tooltip">{{ row?.descriptionLong }}</span>
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span *ngIf="column['property'] != 'adjustmentCode'">{{row[column['property']]}}</span>
<span *ngIf="column['property'] === 'adjustmentCode'" class="tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_6">{{ row?.adjustmentCode }}</a>
<span id="SPN_wildcard_ohiClaims_6" role="tooltip">{{ row?.descriptionLong }}</span>
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- -->
<!-- Medicare Inpatient Section -->
<div *ngIf="secondaryOhiInfo?.showMedicareInPatient" class="col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<h5>Medicare Inpatient Adjudication</h5>
</div>
<div *ngIf="secondaryOhiInfo?.showMedicareInPatient" class="info-table">
<div class="col one">
<table id="TBL_medInpatient_ohiClaimAdj_1" class="wide-header">
<tbody>
<tr>
<th>
Covered Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Lifetime Reserve Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Lifetime Psych. Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim DRG Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim Disproportionate Share:
</th>
<td *ngIf='secondaryOhiInfo.medicareInPatientAdjudicationBean?.claimDisproportionateShare'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare"
[rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
MSP Pass-Thru Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim PPS Capital Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital FSP DRG:
</th>
<td *ngIf='secondaryOhiInfo.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital HSP DRG:
</th>
<td *ngIf='secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<!-- Labels edited to match wireframes -->
<tr>
<th>
PPS Claim Capital DSH DRG:
</th>
<td *ngIf='secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="col one no-flow">
<table id="TBL_medInpatient_ohiClaimAdj_2" class="wide-header">
<tbody>
<tr>
<th>
PPS Oper. Fed. Spec. DRG Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount"
[rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Old Capital Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital IME Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Oper. Hosp. Spec. DRG Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount"
[rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital Outlier Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim Indirect Teaching Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount"
[rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Non-Payable Prof. Component:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent"
[rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital Exception Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount"
[rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Cost Report Day Count:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount" [rightSideData]="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount">
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- RARCs Table -->
<!-- Put conditionals in this DIV -->
<div *ngIf="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes" class="row col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div *ngIf="secondaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes.length > 0" class="fix">
<div *ngFor="let r of secondaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes; let i = index" class="rarc-code">
<div class="label" style="width: 183px;">Remit. Remark Code:</div>
<div class="code">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes[i]?.code"
[rightSideData]="r?.code">
{{ r?.code }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ r?.code }}
</span>
</ng-container>
</div>
<div [ngClass]="{'split': isSplitView}">
<div class="description tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_7">
{{ r?.remarkLong }}
</a>
<span id="SPN_wildcard_ohiClaims_7" role="tooltip">{{ r.code }} : {{ r.remarkLong }}</span>
</div>
</div>
<!-- <div class="code"> {{r.code}}</div>
<app-tooltip [data]='r' [type]='"remark"'></app-tooltip> -->
<!-- <div class="description"> {{r.remarkLong}}</div> -->
</div>
</div>
</div>
</div>
<!-- Medicare Outpatient Section -->
<div *ngIf="secondaryOhiInfo?.showMedicareOutPatient" class="col three"
[ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div class="row" style="margin-bottom: 15px; border-bottom: 1px solid #ccc;"></div>
<h5 id="HDG_medicareOutpatientAdjudication_ohiClaimAdjustments_2">Medicare Outpatient Adjudication</h5>
</div>
<div *ngIf="secondaryOhiInfo?.showMedicareOutPatient" class="info-table">
<div class="col one">
<table id="medicare-outpatient-table-small" class="wide-header">
<tbody>
<tr>
<th id="TH_reimbursementRate_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
Reimbursement Rate:
</th>
<td id="TD_reimbursementRate_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate" [rightSideData]="secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate">
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_claimHcpcsPayAmt_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
Claim HCPCS Pay Amt:
</th>
<td id="TD_claimHcpcsPayAmt_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount"
[rightSideData]="secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount">
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="col one no-flow">
<table id="medicare-outpatient-table-small" class="wide-header">
<tbody>
<tr>
<th id="TH_esrdPaidAmount_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
ESRD Paid Amount:
</th>
<td id="TD_esrdPaidAmount_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount" [rightSideData]="secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount">
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_nonPayableProf_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
Non-Payable Prof:
</th>
<td id="TD_nonPayableProf_medicareOutpatientAdjudication_ohiClaimAdjustments_2">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount"
[rightSideData]="secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount">
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- RARCs Table -->
<!-- Put conditionals in this DIV -->
<div *ngIf="secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes" class="row col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div *ngIf="secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes.length > 0" class="fix">
<div *ngFor="let r of secondaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes; let i = index" class="rarc-code">
<div class="label" style="width: 183px;">Remit. Remark Code:</div>
<div class="code">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareSecondaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes[i]?.code"
[rightSideData]="r?.code">
{{ r?.code }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ r?.code }}
</span>
</ng-container>
</div>
<div [ngClass]="{'split': isSplitView}">
<div class="description tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_8">
{{ r?.remarkLong }}
</a>
<span id="SPN_wildcard_ohiClaims_8" role="tooltip">{{ r?.code }} : {{ r?.remarkLong }}</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- Tertiary OHI Payer -->
<div *ngIf="tertiaryOhiInfo">
<!-- OHI Section Break -->
<div *ngIf="secondaryOhiInfo" class="row" style="margin-bottom: 15px; border-bottom: 3px solid #999;"></div>
<div class="info-table">
<div class="row col one">
<table id="TH_tertiaryOhiInfo_ohiClaimAdjustments_1" class="wide-header">
<tbody>
<tr>
<th id="TH_tertiaryOhiInfo_ohiPayerId_ohiClaimAdjustments_1">
<h5>Tertiary Payer ID:</h5>
</th>
<td id="TD_tertiaryOhiInfo_ohiPayerId_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.ohiPayerID" [rightSideData]="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.ohiPayerID">
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.ohiPayerID }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.ohiPayerID }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_tertiaryOhiInfo_paymentSequenceIndicator_ohiClaimAdjustments_1">
Payment Seq. Indicator:
</th>
<td id="TD_tertiaryOhiInfo_paymentSequenceIndicator_ohiClaimAdjustments_1">T</td>
</tr>
<tr>
<th id="TH_tertiaryOhiInfo_fillingIndicator_ohiClaimAdjustments_1">
Filing Indicator:
</th>
<td id="TD_tertiaryOhiInfo_fillingIndicator_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.claimOhiHeaderBean?.filingIndicator" [rightSideData]="tertiaryOhiInfo?.claimOhiHeaderBean?.filingIndicator">
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.filingIndicator }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.filingIndicator }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_tertiaryOhiInfo_claimAdjustmentDate_ohiClaimAdjustments_1">
Claim Adjustment Date:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate" [rightSideData]="tertiaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate">
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.claimAdjustmentDate }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- -->
<div class="row col one no-flow">
<table id="TH_tertiaryOhiInfo_ohiClaimAdjustments_2" class="wide-header">
<tbody>
<tr>
<th id="TH_tertiaryOhiInfo_ohiPayerName_ohiClaimAdjustments_1">
<h5>Other Payer Name:</h5>
</th>
<td id="TD_tertiaryOhiInfo_ohiPayerName_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.claimOhiHeaderBean?.otherPayerName" [rightSideData]="tertiaryOhiInfo?.claimOhiHeaderBean?.otherPayerName">
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.otherPayerName }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.otherPayerName }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_tertiaryOhiInfo_ohiGroupName_ohiClaimAdjustments_1">
OHI Group Name:
</th>
<td id="TD_tertiaryOhiInfo_ohiGroupName_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName" [rightSideData]="tertiaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName">
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.ohiGroupName }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_tertiaryOhiInfo_insuranceType_ohiClaimAdjustments_1">
Insurance Type:
</th>
<td id="TD_tertiaryOhiInfo_insuranceType_ohiClaimAdjustments_1">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.claimOhiHeaderBean?.insuranceType" [rightSideData]="tertiaryOhiInfo?.claimOhiHeaderBean?.insuranceType">
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.insuranceType }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.claimOhiHeaderBean?.insuranceType }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<!-- TODO add highlighting to dynamic table -->
<div *ngIf="tertiaryClaimAdjustmentsTableInfoRows.length > 0" class="row col two">
<!-- <app-table id="CMP_tertiaryOhiInfo_table_ohiClaimAdjustments_1" [columns]="tertiaryClaimAdjustmentsTableColumns" [loading]="loading"
[rows]="tertiaryClaimAdjustmentsTableInfoRows" [paginationSettings]="paginationSettings" [tableSettings]="tableSettings">
</app-table> -->
<table id="TBL_yertiaryOhiInfo_table_ohiClaimAdjustments_1" class="ewv-table">
<thead>
<tr>
<th class="clickable" *ngFor="let column of tertiaryClaimAdjustmentsTableColumns">
<label for="{{column['title']}}">{{column['title']}}</label>
</th>
</tr>
</thead>
<tbody>
<tr *ngFor="let row of tertiaryClaimAdjustmentsTableInfoRows; let i = index">
<td *ngFor="let column of tertiaryClaimAdjustmentsTableColumns">
<ng-container *ngIf="isRightSide">
<ng-container *ngIf="compareTertiaryClaimAdjustmentsTableInfoRows[i]">
<span *ngIf="column['property'] != 'adjustmentCode'" appHighlight [leftSideData]="compareTertiaryClaimAdjustmentsTableInfoRows[i][column['property']]"
[rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<ng-container *ngIf="!compareTertiaryClaimAdjustmentsTableInfoRows[i]">
<span *ngIf="column['property'] != 'adjustmentCode'" appHighlight [leftSideData]="''" [rightSideData]="row[column['property']]">
{{row[column['property']]}}
</span>
</ng-container>
<span *ngIf="column['property'] === 'adjustmentCode'" class="tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_9">{{ row?.adjustmentCode }}</a>
<span id="SPN_wildcard_ohiClaims_9" role="tooltip">{{ row?.descriptionLong }}</span>
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span *ngIf="column['property'] != 'adjustmentCode'">{{row[column['property']]}}</span>
<span *ngIf="column['property'] === 'adjustmentCode'" class="tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_10">{{ row?.adjustmentCode }}</a>
<span id="SPN_wildcard_ohiClaims_10" role="tooltip">{{ row?.descriptionLong }}</span>
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- Medicare Inpatient Section -->
<div *ngIf="tertiaryOhiInfo.showMedicareInPatient" class="col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<h5>Medicare Inpatient Adjudication</h5>
</div>
<div *ngIf="tertiaryOhiInfo.showMedicareInPatient" class="info-table">
<div class="col one">
<table id="TBL_medInpatient_ohiClaimAdj_1" class="wide-header">
<tbody>
<tr>
<th>
Covered Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.coveredDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Lifetime Reserve Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimeReserveDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Lifetime Psych. Days:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.lifetimePsychiatricDays }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim DRG Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim Disproportionate Share:
</th>
<td *ngIf='tertiaryOhiInfo.medicareInPatientAdjudicationBean?.claimDisproportionateShare'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare"
[rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimDisproportionateShare }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
MSP Pass-Thru Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.mspPassThruAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim PPS Capital Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimPpsCapitalAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital FSP DRG:
</th>
<td *ngIf="tertiaryOhiInfo.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount" >
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalFspDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital HSP DRG:
</th>
<td *ngIf='tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalHspDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Claim Capital DSH DRG:
</th>
<td *ngIf='tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount'>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalDshDrugAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="col one no-flow">
<table id="TBL_medInpatient_ohiClaimAdj_2" class="wide-header">
<tbody>
<tr>
<th>
PPS Oper. Fed. Spec. DRG Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount"
[rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperatingFederalSpecDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Old Capital Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.oldCapitalAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital IME Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalImeAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Oper. Hosp. Spec. DRG Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount"
[rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsOperHospitalSpecicalDrugAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital Outlier Amount:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalOutlierAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Claim Indirect Teaching Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount"
[rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.claimIndirectTeachingAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Non-Payable Prof. Component:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent"
[rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.nonPayableProfessionalComponent }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
PPS Capital Exception Amt:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount"
[rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.ppsCapitalExceptionAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th>
Cost Report Day Count:
</th>
<td>
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount" [rightSideData]="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount">
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.costReportDayCount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<!-- RARCs Table -->
<!-- Put conditionals in this DIV -->
<div *ngIf="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes" class="row col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div *ngIf="tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes.length > 0" class="fix">
<div *ngFor="let r of tertiaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes; let i = index" class="rarc-code">
<div class="label" style="width: 183px;">Remit. Remark Code:</div>
<div class="code">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareInPatientAdjudicationBean?.remittanceRemarkCodes[i]?.code"
[rightSideData]="r?.code">
{{ r?.code }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ r?.code }}
</span>
</ng-container>
</div>
<div [ngClass]="{'split': isSplitView}">
<div class="description tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_11">
{{ r.remarkLong }}
</a>
<span id="SPN_wildcard_ohiClaims_11" role="tooltip">{{ r?.code }} : {{ r?.remarkLong }}</span>
</div>
</div>
</div>
</div>
</div>
</div> <!-- End of tertiary inpatient section-->
</div>
<!-- Medicare Outpatient Section -->
<div *ngIf="tertiaryOhiInfo?.showMedicareOutPatient" class="col three"
[ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div class="row" style="margin-bottom: 15px; border-bottom: 1px solid #ccc;"></div>
<h5 id="HDG_medicareOutpatientAdjudication_ohiClaimAdjustments_3">Medicare Outpatient Adjudication</h5>
</div>
<div *ngIf="tertiaryOhiInfo?.showMedicareOutPatient" class="info-table">
<div class="col one">
<table id="medicare-outpatient-table-small" class="wide-header">
<tbody>
<tr>
<th id="TH_reimbursementRate_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
Reimbursement Rate:
</th>
<td id="TD_reimbursementRate_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate" [rightSideData]="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate">
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.reimbursementRate }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_claimHcpcsPayAmt_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
Claim HCPCS Pay Amt:
</th>
<td id="TD_claimHcpcsPayAmt_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount" [rightSideData]="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount">
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.claimHcpcsPayableAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div class="col one no-flow">
<table id="medicare-outpatient-table-small" class="wide-header">
<tbody>
<tr>
<th id="TH_esrdPaidAmount_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
ESRD Paid Amount:
</th>
<td id="TD_esrdPaidAmount_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount" [rightSideData]="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount">
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.esrdPaidAmount }}
</span>
</ng-container>
</td>
</tr>
<tr>
<th id="TH_nonPayableProf_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
Non-Payable Prof:
</th>
<td id="TD_nonPayableProf_medicareOutpatientAdjudication_ohiClaimAdjustments_3">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount"
[rightSideData]="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount">
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount ==='\u2013\u2013\u2013' ? '\u2013\u2013\u2013' : '$'+
tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.nonPayableProfessionalComponentAmount }}
</span>
</ng-container>
</td>
</tr>
</tbody>
</table>
</div>
<div *ngIf="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes" class="row col three" [ngStyle]="{'width': isSplitView ? '788px' : '1191px'}">
<div *ngIf="tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes.length > 0" class="fix">
<div *ngFor="let r of tertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes; let i = index" class="rarc-code">
<div class="label" style="width: 183px;">Remit. Remark Code:</div>
<div class="code">
<ng-container *ngIf="isRightSide">
<span appHighlight [leftSideData]="compareTertiaryOhiInfo?.medicareOutPatientAdjudicationBean?.remittanceRemarkCodes[i]?.code"
[rightSideData]="r?.code">
{{ r?.code }}
</span>
</ng-container>
<ng-container *ngIf="!isRightSide">
<span>
{{ r?.code }}
</span>
</ng-container>
</div>
<div [ngClass]="{'split': isSplitView}">
<div class="description tooltip">
<a [tabindex]="tabbableIdx" aria-describedby="SPN_wildcard_ohiClaims_12">
{{ r?.remarkLong }}
</a>
<span id="SPN_wildcard_ohiClaims_12" role="tooltip">{{ r?.code }} : {{ r?.remarkLong }}</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>