/**
* Produce an html display of information in
* the x12 edi 271 eligibility report for a particular patient
*
* @uses edih_271_codes()
* @uses edih_format_money()
* @uses edih_format_date()
* @uses edih_format_percent()
*
* @param object edih_x12_file type 271
* @param string bht03 or clm01 reference for transaction
* @return string
*/
function edih_271_transaction_html($obj271, $bht03)
{
//
$trans = $obj271->edih_x12_transaction($bht03);
if (empty($trans) || !count($trans)) {
$str_html = "<p>Did not find transaction {$bht03} in " . $obj271->edih_filename() . "</p>";
return $str_html;
}
$de = $obj271->edih_delimiters()['e'];
$ds = $obj271->edih_delimiters()['s'];
$dr = $obj271->edih_delimiters()['r'];
$fn = $obj271->edih_filename();
//
$cd271 = new edih_271_codes($ds, $dr);
//
$str_html = "";
//
$hdr_html = "<table id={$bht03} class='h271' columns=4><caption>Eligibility Benefit Response</caption>" . PHP_EOL;
$hdr_html .= "<thead>" . PHP_EOL;
$hdr_html .= "<tr><th>Reference</th><th colspan=2>Information</th><th colspan=2>{$fn}</th></tr>" . PHP_EOL;
$hdr_html .= "</thead>" . PHP_EOL . "<tbody>" . PHP_EOL;
$src_html = "";
$rcv_html = "";
$sbr_nm1_html = "";
$dep_nm1_html = "";
$sbr_ref_html = "";
$dep_ref_html = "";
$sbr_eb_html = "";
$dep_eb_html = "";
//
$ebct = 0;
//
$trns_ct = count($trans);
for ($i = 0; $i < $trns_ct; $i++) {
foreach ($trans[$i] as $seg) {
//
$idtype = '';
$name = '';
$var = '';
$rej_reason = '';
$follow = '';
$addr = '';
//
if (strncmp('BHT' . $de, $seg, 4) === 0) {
$loopid = 'Heading';
$sar = explode($de, $seg);
$bht01 = isset($sar[1]) && $sar[1] == '022' ? "Src, Rcv, Sbr, Dep" : "Order unspecified";
$bht02 = isset($sar[2]) && $sar[2] == '11' ? "Response" : "Confirmation";
$bht03 = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$bht04 = isset($sar[4]) && $sar[4] ? edih_format_date($sar[4]) : "";
//
$hdr_html .= "<tr><td><em>Reference:</em> {$bht03}</td><td><em>Date:</em> {$bht04}</td><td><em>Type:</em> {$bht02}</td><td>{$bht01}</td></tr>" . PHP_EOL;
continue;
}
//
if (strncmp('HL' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
if ($sar[3] == '20') {
// level code
$loopid = '2000A';
// info source (payer)
$src_html .= "<tr><td colspan=4><b>Information Source</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == '21') {
$loopid = '2000B';
// info receiver (clinic)
$rcv_html .= "<tr><td colspan=4><b>Information Receiver</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == '22') {
$loopid = '2000C';
// subscriber
$has_eb = false;
$sbr_nm1_html .= "<tr><td colspan=4><b>Subscriber</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == '23') {
$loopid = '2000D';
// dependent
$has_eb = false;
$dep_nm1_html .= "<tr><td colspan=4><b>Dependent</b></td></tr>" . PHP_EOL;
}
//
$ebct = 0;
continue;
}
//
if (strncmp('AAA' . $de, $seg, 4) === 0) {
// rejection
$sar = explode($de, $seg);
$rej_reason = $cd271->get_271_code('AAA03', $sar[3]);
$follow = $cd271->get_271_code('AAA04', $sar[4]);
if ($loopid == '2000A') {
$src_html .= "<tr><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000B') {
$rcv_html .= "<tr><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000C') {
$sbr_nm1_html .= "<tr><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000D') {
$dep_nm1_html .= "<tr><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2110C') {
$sbr_eb_html .= "<tr class={$cls}><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2110D') {
$dep_eb_html .= "<tr class={$cls}><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} else {
$hdr_html .= "<tr><td>{$loopid} <em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
}
continue;
}
if (strncmp('NM1' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$descr = isset($sar[1]) && $sar[1] ? $cd271->get_271_code('NM101', $sar[1]) : "";
//
$name = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$name .= isset($sar[7]) && $sar[7] ? " {$sar[7]}" : "";
$name .= isset($sar[4]) && $sar[4] ? ", {$sar[4]}" : "";
$name .= isset($sar[5]) && $sar[5] ? " {$sar[5]}" : "";
$name .= isset($sar[7]) && $sar[7] ? " {$sar[7]}" : "";
//
$idtype = isset($sar[8]) && $sar[8] ? $cd271->get_271_code('NM108', $sar[8]) : "";
$nm109 = isset($sar[9]) && $sar[9] ? $sar[9] : "";
//
if ($loopid == '2000A') {
$src_html .= "<tr><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2100A';
} elseif ($loopid == '2000B') {
$rcv_html .= "<tr><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2100B';
} elseif ($loopid == '2000C') {
$sbr_nm1_html .= "<tr><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2100C';
} elseif ($loopid == '2000D') {
$dep_nm1_html .= "<tr><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2100D';
} elseif ($loopid == '2120C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td title='{$idtype}'>{$nm109}</td><td colspan=2 title='{$descr}'>{$descr} {$name}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td title='{$idtype}'>{$nm109}</td><td colspan=2 title='{$descr}'>{$descr} {$name}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('PER' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$per02 = isset($sar[2]) && $sar[2] ? $sar[2] : '';
$idtype = isset($sar[3]) && $sar[3] ? $cd271->get_271_code('PER03', $sar[3]) : "";
$per04 = isset($sar[4]) && $sar[2] ? $sar[4] : '';
if ($loopid == '2100A') {
$src_html .= "<tr><td colspan=3>{$per02}</td><td title='{$idtype}'>{$per04}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td title='{$idtype}'>{$per04}</td><td colspan=2>{$per02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td title='{$idtype}'>{$per04}</td><td colspan=2>{$per02}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('N3' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
$addr = isset($sar[1]) ? $sar[1] : "";
$addr .= isset($sar[2]) ? " {$sar[2]}" : "";
if ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('N4' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
if ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('PRV' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$idtype = $sar[1] ? $cd271->get_271_code('PRV', $sar[1]) : "";
if ($loopid == '2100B') {
$src_html .= "<tr><td colspan=3>{$sar[2]}</td><td title='{$idtype}'>{$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td title='{$idtype}'>{$sar[3]}</td><td colspan=3>{$sar[2]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td title='{$idtype}'>{$sar[3]}</td><td colspan=3>{$sar[2]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td title='{$idtype}'>{$sar[3]}</td><td colspan=2>{$sar[2]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2120D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td title='{$idtype}'>{$sar[3]}</td><td colspan=2>{$sar[2]}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('DMG' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$dmg02 = isset($sar[2]) && $sar[2] ? edih_format_date($sar[2]) : "";
if (isset($sar[3]) && $sar[3]) {
if ($sar[3] == 'M') {
$dmg03 = "Male";
} elseif ($sar[3] == 'F') {
$dmg03 = "Female";
} else {
$dmg03 = "Unknown";
}
}
if ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td>></td><td>{$dmg03}</td><td colspan=2><em>Date of Birth</em> {$dmg02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td>></td><td>{$dmg03}</td><td colspan=2><em>Date of Birth</em> {$dmg02}</td></tr>" . PHP_EOL;
}
continue;
}
if (strncmp('INS' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$ins01 = isset($sar[1]) && $sar[1] == 'Y' ? "Subscriber" : "Dependent";
$ins02 = isset($sar[2]) && $sar[2] ? $cd271->get_271_code('INS02', $sar[2]) : "";
$ins03 = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$ins04 = isset($sar[4]) && $sar[4] == '25' ? "<b>Information changed</b>" : "";
$ins17 = isset($sar[17]) && $sar[17] ? $sar[17] : "";
//
if ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td>></td><td>{$ins01} {$ins17}</td><td>{$ins02}</td><td>{$ins03} {$ins04}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td>></td><td>{$ins01} {$ins17}</td><td>{$ins02}</td><td>{$ins03} {$ins04}</td></tr>" . PHP_EOL;
}
continue;
}
if (strncmp('DTP' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
$var = '';
$dtp01 = isset($sar[1]) ? $sar[1] : '';
$dtp02 = isset($sar[2]) ? $sar[2] : '';
$dtp03 = isset($sar[3]) ? $sar[3] : '';
//
$idtype = $dtp01 ? $cd271->get_271_code('DTP', $dtp01) : "";
if ($dtp02 == 'D8' && $dtp03) {
$var = edih_format_date($dtp03);
} elseif ($dtp02 == 'RD8' && $dtp03) {
$var = edih_format_date(substr($dtp03, 0, 8));
$var .= ' - ' . edih_format_date(substr($dtp03, -8));
}
if ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td>></td><td>{$idtype}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td>></td><td>{$idtype}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2110C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td>{$idtype}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2110D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td>{$idtype}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('MPI' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$idtype = isset($sar[1]) && $sar[1] ? $cd271->get_271_code('MPI', $sar[1]) : "";
$idtype .= isset($sar[2]) && $sar[2] ? $cd271->get_271_code('MPI', $sar[2]) : "";
$idtype .= isset($sar[3]) && $sar[3] ? $cd271->get_271_code('MPI', 'SB' . $sar[3]) : "";
if (isset($sar[7]) && isset($sar[8])) {
if ($sar[7] == 'D8') {
$var = edih_format_date($sar[8]);
} elseif ($sar[7] == 'RD8') {
$var = edih_format_date(substr($sar[8], 0, 8));
$var .= ' - ' . edih_format_date(substr($sar[8], -8));
}
}
if ($loopid == '2100C') {
$sbr_nm1_html .= "<tr><td colspan=3>{$idtype}</td><td>{$var}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_nm1_html .= "<tr><td colspan=3>{$idtype}</td><td>{$var}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('EB' . $de, $seg, 3) === 0) {
//
$ebct++;
$cls = $ebct % 2 ? 'ebe' : 'ebo';
$sar = explode($de, $seg);
//
$eb01 = $cd271->get_271_code('EB01', $sar[1]);
// eligibility or benefit
$eb02 = isset($sar[2]) && $sar[2] ? $cd271->get_271_code('EB02', $sar[2]) : '';
// coverage level
$eb03 = isset($sar[3]) && $sar[3] ? $cd271->get_271_code('EB03', $sar[3]) : '';
// service type
$eb04 = isset($sar[4]) && $sar[4] ? $cd271->get_271_code('EB04', $sar[4]) : '';
// insurance type
$eb05 = isset($sar[5]) && $sar[5] ? $sar[5] : '';
// descriptive (plan name)
$eb06 = isset($sar[6]) && $sar[6] ? $cd271->get_271_code('EB06', $sar[6]) : '';
// time qualifier
$eb07 = isset($sar[7]) && strlen($sar[7]) ? edih_format_money($sar[7]) : '';
// monetary amount
$eb08 = isset($sar[8]) && $sar[8] ? edih_format_percent($sar[8]) : '';
// percentage amount
$eb09 = isset($sar[9]) && $sar[9] ? $cd271->get_271_code('EB09', $sar[9]) : '';
// Quantity qualifier
$eb10 = isset($sar[10]) && $sar[10] ? $sar[10] : '';
// quantity
$eb11 = isset($sar[11]) && $sar[11] ? $cd271->get_271_code('EB11', $sar[11]) : '';
// authorization required?
$eb12 = isset($sar[12]) && $sar[12] ? $cd271->get_271_code('EB12', $sar[12]) : '';
// in network?
$eb13 = "";
if (isset($sar[13]) && strpos($sar[13], $ds)) {
// composite procedure ID
$eb13ar = explode($ds, $sar[13]);
reset($eb13ar);
while (list($k, $v) = each($eb13ar)) {
if ($k == 0) {
$eb13 = $cd271->get_271_code('EB13', $v);
} else {
$eb13 .= " " . $v;
}
}
} else {
$eb13 = $sar[13] ? "<em>Procedure</em> {$eb13}" : "";
}
$eb14 = "";
if (isset($sar[14])) {
if (strpos($sar[14], $ds)) {
// composite diagnosis pointer
$eb14 = str_replace($ds, " | ", $sar[14]);
} else {
$eb14 = $sar[14];
}
$eb14 = $eb14 ? "<em>Pointers</em> {$eb14}" : "";
}
// if LS - LE segments loop should be 2110C or 2110D
if ($loopid == '2100C' || $loopid == '2110C') {
$loopid = '2110C';
if (strpos('|A|B', $sar[1]) !== false) {
$sbr_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb07} {$eb08}</td><td colspan=2>{$eb02} {$eb03} {$eb04} {$eb06}</td></tr>" . PHP_EOL;
} elseif (strpos('|C|G|J|Y', $sar[1]) !== false) {
$sbr_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb02}</td><td>{$eb06} {$eb07}</td><td>{$eb03} {$eb04}</td></tr>" . PHP_EOL;
} elseif (strpos('|E|F|', $sar[1]) !== false) {
$sbr_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb02}</td><td colspan=2>{$eb03} {$eb04} {$eb06}</td></tr>" . PHP_EOL;
} else {
$sbr_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb02}</td><td colspan=3>{$eb07} {$eb08} {$eb03} {$eb04} {$eb06}</td></tr>" . PHP_EOL;
}
$sbr_eb_html .= $eb09 || $eb10 || $eb11 || $eb12 ? "<tr class={$cls}><td colspan=2>></td><td colspan=2>{$eb09} {$eb10} {$eb11} {$eb12}</td></tr>" . PHP_EOL : "";
$sbr_eb_html .= $eb13 || $eb14 ? "<tr class={$cls}><td>></td><td colspan=3>{$eb13} {$eb14} </td></tr>" . PHP_EOL : "";
$sbr_eb_html .= $eb05 ? "<tr class={$cls}><td>></td><td colspan=3>{$eb05}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '2100D' || $loopid == '2110D') {
$loopid = '2110D';
if (strpos('|A|B', $eb01) && !$eb02) {
$dep_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$ebo7} {$eb08}</td><td colspan=2>{$eb03} {$eb04} {$eb06}</td></tr>" . PHP_EOL;
} elseif (strpos('|C|G|J|Y', $eb01)) {
$dep_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb02}</td><td>{$eb07} {$eb08}</td><td>{$eb11} {$eb12}</td></tr>" . PHP_EOL;
} elseif (strpos('|E|F|', $eb01)) {
$dep_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb02}</td><td colspan=2>{$eb03} {$eb04} {$eb06} </td></tr>" . PHP_EOL;
} else {
$dep_eb_html .= "<tr class={$cls}><td>{$eb01}</td><td>{$eb02}</td><td colspan=3>{$eb07} {$eb08} {$eb03} {$eb04} {$eb06} </td></tr>" . PHP_EOL;
}
$dep_eb_html .= $eb09 || $eb10 || $eb11 || $eb12 ? "<tr class={$cls}><td>></td><td colspan=3>{$eb09} {$eb10} {$eb11} {$eb12}</td></tr>" . PHP_EOL : "";
$dep_eb_html .= $eb13 || $eb14 ? "<tr class={$cls}><td>></td><td colspan=3>{$eb13} {$eb14} </td></tr>" . PHP_EOL : "";
$dep_eb_html .= $eb05 ? "<tr class={$cls}><td>></td><td colspan=3>{$eb05}</td></tr>" . PHP_EOL : "";
}
continue;
}
//
if (strncmp('HSD' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$hsd01 = isset($sar[1]) && $sar[1] ? $cd271->get_271_code('HSD01', $sar[1]) : '';
// quantity qualifier
$hsd02 = isset($sar[2]) && $sar[2] ? $sar[2] : '';
// numeric quantity
$hsd03 = isset($sar[3]) && $sar[3] ? $cd271->get_271_code('HSD01', $sar[3]) : '';
// measurement unit
$hsd04 = isset($sar[4]) && $sar[4] ? $sar[4] : '';
// sample selection modulus
$hsd05 = isset($sar[5]) && $sar[5] ? $cd271->get_271_code('EB06', $sar[5]) : '';
// time period qualifier
$hsd06 = isset($sar[6]) && $sar[6] ? $sar[6] : '';
// number of periods
$hsd07 = isset($sar[7]) && $sar[7] ? $cd271->get_271_code('HSD07', $sar[7]) : '';
// delivery
$hsd08 = isset($sar[8]) && $sar[8] ? $cd271->get_271_code('HSD08', $sar[8]) : '';
// delivery
//
if ($loopid == '2110C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td>{$hsd01} : {$hsd02}</td><td>{$hsd03} : {$hsd04}</td><td>{$hsd05} : {$hsd06}</td></tr>" . PHP_EOL;
$sbr_eb_html .= $hsd07 || $hsd08 ? "<tr class={$cls}><td>></td><td colspan=3>{$hsd07} {$hsd08}</td></tr>" . PHP_EOL : '';
} elseif ($loopid == '2110D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td>{$hsd01} : {$hsd02}</td><td>{$hsd03} : {$hsd04}</td><td>{$hsd05} : {$hsd06}</td></tr>" . PHP_EOL;
$dep_eb_html .= $hsd07 || $hsd08 ? "<tr class={$cls}><td>></td><td colspan=3>{$hsd07} {$hsd08}</td></tr>" . PHP_EOL : '';
}
continue;
}
if (strncmp('REF' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$ref01 = isset($sar[1]) && $sar[1] ? $cd271->get_271_code('REF', $sar[1]) : '';
// identification qualifier
$ref02 = isset($sar[2]) && $sar[2] ? $sar[2] : '';
// identification value
$ref03 = isset($sar[3]) && $sar[3] ? $sar[3] : '';
// description
//
if ($loopid == '2100C') {
$sbr_ref_html .= "<tr><td>></td><td colspan=2>{$ref03}</td><td>{$ref01} {$ref02} </td></tr>" . PHP_EOL;
} elseif ($loopid == '2100D') {
$dep_ref_html .= "<tr><td>></td><td colspan=2>{$ref03}</td><td>{$ref01} {$ref02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2110C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td colspan=2>{$ref03}</td><td>{$ref01} {$ref02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2110D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td colspan=2>{$ref03}</td><td>{$ref01} {$ref02}</td></tr>" . PHP_EOL;
}
continue;
}
if (strncmp('MSG' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$msg01 = isset($sar[1]) && $sar[1] ? $sar[1] : '';
if ($msg01 && $loopid == '2110C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$msg01}</td></tr>" . PHP_EOL;
} elseif ($msg01 && $loopid == '2110D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$msg01}</td></tr>" . PHP_EOL;
}
continue;
}
if (strncmp('III' . $de, $seg, 4) === 0 && ($loopid == '2110C' || $loopid == '2110D')) {
$sar = explode($de, $seg);
if (isset($sar[1]) && ($sar[1] == 'GR' || $sar[1] == 'NI')) {
$iii02 = isset($sar[2]) && $sar[2] ? $cd271->get_271_code('IIIGR', $sar[2]) : '';
} else {
$iii02 = isset($sar[2]) && $sar[2] ? $cd271->get_271_code('POS', $sar[2]) : '';
}
$iii03 = isset($sar[3]) && $sar[3] ? $sar[3] : '';
//
if ($loopid == '2110C') {
$sbr_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$iii02}</td></tr>" . PHP_EOL;
$sbr_eb_html .= $iii03 ? "<tr class={$cls}><td>></td><td colspan=3>{$iii03}</td></tr>" . PHP_EOL : '';
} elseif ($loopid == '2110D') {
$dep_eb_html .= "<tr class={$cls}><td>></td><td colspan=3>{$iii02}</td></tr>" . PHP_EOL;
$dep_eb_html .= $iii03 ? "<tr class={$cls}><td>></td><td colspan=3>{$iii03}</td></tr>" . PHP_EOL : '';
}
continue;
}
//
if (strncmp('LS' . $de, $seg, 3) === 0) {
if ($loopid == '2110C') {
$loopid = '2120C';
}
if ($loopid == '2110D') {
$loopid = '2120D';
}
continue;
}
if (strncmp('LE' . $de, $seg, 3) === 0) {
if ($loopid == '2120C') {
$loopid = '2100C';
}
if ($loopid == '2120D') {
$loopid = '2100D';
}
continue;
}
//
}
//
$str_html .= $hdr_html;
$str_html .= $src_html ? $src_html : "";
$str_html .= $rcv_html ? $rcv_html : "";
$str_html .= $sbr_nm1_html ? $sbr_nm1_html : "";
$str_html .= $sbr_ref_html;
$str_html .= $sbr_eb_html;
$str_html .= $dep_nm1_html ? $dep_nm1_html : "";
$str_html .= $dep_ref_html;
$str_html .= $dep_eb_html;
$str_html .= "<tr><td colspan=4> </td></tr>" . PHP_EOL;
$str_html .= "</tbody>" . PHP_EOL . "</table>" . PHP_EOL;
}
//
return $str_html;
}
function edih_278_transaction_html($obj278, $bht03)
{
//
$trans = $obj278->edih_x12_transaction($bht03);
if (empty($trans)) {
$str_html = $obj278->edih_message();
return $str_html;
}
$de = $obj278->edih_delimiters()['e'];
$ds = $obj278->edih_delimiters()['s'];
$dr = $obj278->edih_delimiters()['r'];
$fn = $obj278->edih_filename();
//
$cd27x = new edih_271_codes($ds, $dr);
//
$cls = '';
$capstr = 'Services Review (Cert/Auth)';
//
$hdr_html = "<table class='h278' columns=4><caption>{$capstr}</caption>";
$hdr_html .= "<thead><tr><th>Reference</th><th>Information</th><th colspan=2>{$fn}</th></tr></thead>" . PHP_EOL;
$hdr_html .= "<tbody>" . PHP_EOL;
$str_html = "";
$src_html = "";
$rcv_html = "";
$sbr_nm1_html = "";
$dep_nm1_html = "";
$evt_html = "";
$svc_html = "";
//
$trns_ct = count($trans);
for ($i = 0; $i < $trns_ct; $i++) {
foreach ($trans[$i] as $seg) {
//
$idtype = '';
$name = '';
$var = '';
$rej_reason = '';
$follow = '';
$addr = '';
// debug
//
if (strncmp('BHT' . $de, $seg, 4) === 0) {
$loopid = 'Heading';
$sar = explode($de, $seg);
$elem01 = $sar[1] == '0007' ? "Src, Rcvr, Sbr, Dep, Evt, Svc" : "Not determined";
//
$elem02 = isset($sar[2]) && $sar[2] !== false ? $cd27x->get_271_code('BHT02', $sar[2]) : "";
//
$elem03 = isset($sar[3]) ? $sar[3] : '';
$elem04 = isset($sar[4]) ? edih_format_date($sar[4]) : '';
//
$elem06 = isset($sar[6]) && $sar[6] ? $cd27x->get_271_code('BHT06', $sar[6]) : "";
//
$hdr_html .= "<tr><td colspan=2><em>Transaction ID:</em> {$elem03} </td><td colspan=2><em>Sequence:</em> {$elem01}</td></tr>" . PHP_EOL;
if ($elem06) {
$hdr_html .= "<tr><td colspan=2><em>Transaction Date:</em> {$elem04} </td><td colspan=2>{$elem02} <em>Type:</em> {$elem06}</td></tr>" . PHP_EOL;
} else {
$hdr_html .= "<tr><td colspan=2><em>Transaction Date:</em> {$elem04} </td><td colspan=2><em>Type:</em> {$elem02}</td></tr>" . PHP_EOL;
}
//
continue;
}
//'src''rcv'sbr''dep''evt''svc''
if (strncmp($seg, 'HL' . $de, 3) === 0) {
$sar = explode($de, $seg);
$hl = $sar[1];
$hlpc = $sar[2];
// parent code
$hllc = $sar[3];
$hlcc = isset($sar[4]) ? $sar[4] : '';
// child code
if ($sar[3] == '20') {
// level code
$loopid = '2000A';
$cls = 'src';
// info source (payer)
$src_html .= "<tr class='{$cls}'><td colspan=4><b>Information Source</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == '21') {
$loopid = '2000B';
$cls = 'rcv';
// info receiver (clinic)
$rcv_html .= "<tr class='{$cls}'><td colspan=4><b>Information Receiver</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == '22') {
$loopid = '2000C';
// subscriber
$cls = 'sbr';
$sbr_nm1_html .= "<tr class='{$cls}'><td colspan=4><b>Subscriber</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == '23') {
$loopid = '2000D';
// dependent
$cls = 'dep';
$dep_nm1_html .= "<tr class='{$cls}'><td colspan=4><b>Dependent</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == 'EV') {
$loopid = '2000E';
// patient event
$cls = 'evt';
$evt_html .= "<tr class='{$cls}'><td colspan=4><b>Patient Event</b></td></tr>" . PHP_EOL;
} elseif ($sar[3] == 'SS') {
$loopid = '2000F';
// service
$cls = 'svc';
$svc_html .= "<tr class='{$cls}'><td colspan=4><b>Service</b></td></tr>" . PHP_EOL;
}
//
continue;
}
if (strncmp('NM1' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$nm101 = isset($sar[1]) ? $sar[1] : '';
$descr = $nm101 ? $cd27x->get_271_code('NM101', $nm101) : "";
//
$name = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$name .= isset($sar[7]) && $sar[7] ? " {$sar[7]}" : "";
$name .= isset($sar[4]) && $sar[4] ? ", {$sar[4]}" : "";
$name .= isset($sar[5]) && $sar[5] ? " {$sar[5]}" : "";
$nm109 = isset($sar[9]) && $sar[9] ? $sar[9] : "";
//
$idtype = isset($sar[8]) && $sar[8] ? $cd27x->get_271_code('NM108', $sar[8]) : "";
//
if ($loopid == '2000A') {
$src_html .= "<tr class='{$cls}'><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2010A';
} elseif ($loopid == '2000B') {
$rcv_html .= "<tr class='{$cls}'><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2010B';
} elseif ($loopid == '2000C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2010C';
} elseif ($loopid == '2000D') {
$dep_nm1_html .= "<tr class='{$cls}'><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$loopid = '2010D';
} elseif ($loopid == '2000E' || strpos($loopid, '010E')) {
$loopid = strpos('|71|72|73|77|AAJ|DD|DK|DN|FA|G3|P3|QB|QV|SJ', $nm101) ? '2010EA' : $loopid;
$loopid = strpos('|45|FS|ND|PW|R3', $nm101) ? '2010EB' : $loopid;
$loopid = $nm101 == 'L5' ? '2010EC' : $loopid;
$evt_html .= "<tr class='{$cls}'><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$descr} {$name}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000F' || strpos($loopid, '010F')) {
$loopid = strpos('|71|72|73|77|AAJ|DD|DK|DN|FA|G3|P3|QB|QV|SJ', $nm101) ? '2010FA' : $loopid;
$loopid = $nm101 == 'L5' ? '2010FB' : $loopid;
$svc_html .= "<tr class='{$cls}'><td title='{$idtype}'>{$nm109}</td><td colspan=3 title='{$descr}'>{$descr} {$name}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('N3' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
$addr = isset($sar[1]) ? $sar[1] : "";
$addr .= isset($sar[2]) ? " {$sar[2]}" : "";
//
if ($loopid == '2010B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010D') {
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010EA' || $loopid == '2010EC') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010FA') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$addr}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('N4' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
if ($loopid == '2010B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010D') {
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010EA' || $loopid == '2010EC') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010FA' || $loopid == '2010FB') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$sar[1]} {$sar[2]} {$sar[3]}</td></tr>" . PHP_EOL;
}
continue;
}
// //
if (strncmp('PER' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$elem01 = isset($sar[1]) ? $sar[1] : '';
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $cd27x->get_271_code('PER03', $sar[3]) : "";
$elem04 = isset($sar[4]) ? $sar[4] : '';
$elem05 = isset($sar[5]) ? $cd27x->get_271_code('PER03', $sar[5]) : "";
$elem06 = isset($sar[6]) ? $sar[6] : '';
$elem07 = isset($sar[7]) ? $cd27x->get_271_code('PER03', $sar[7]) : "";
$elem08 = isset($sar[8]) ? $sar[8] : '';
$elem09 = isset($sar[9]) ? $sar[9] : '';
$idtype = $sar[3] ? $cd27x->get_271_code('PER03', $sar[3]) : "";
if ($loopid == '2010A') {
$src_html .= "<tr class='{$cls}'><td colspan=2>{$elem02}</td><td colspan=2 title='{$elem03} {$elem05} {$elem07}'>{$elem04} {$elem06} {$elem08}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010B') {
$rcv_html .= "<tr class='{$cls}'><td colspan=2>{$elem02}</td><td colspan=2 title='{$elem03} {$elem05} {$elem07}'>{$elem04} {$elem06} {$elem08}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010EA') {
$evt_html .= "<tr class='{$cls}'><td colspan=2>{$elem02}</td><td colspan=2 title='{$elem03} {$elem05} {$elem07}'>{$elem04} {$elem06} {$elem08}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010FA') {
$svc_html .= "<tr class='{$cls}'><td colspan=2>{$elem02}</td><td colspan=2 title='{$elem03} {$elem05} {$elem07}'>{$elem04} {$elem06} {$elem08}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('AAA' . $de, $seg, 4) === 0) {
// rejection
$sar = explode($de, $seg);
$rej_reason = $cd27x->get_271_code('AAA03', $sar[3]);
$follow = $cd27x->get_271_code('AAA04', $sar[4]);
if ($loopid == '2000A') {
$src_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010A') {
$src_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000B') {
$rcv_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010B') {
$sbr_eb_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010C') {
$sbr_eb_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000D') {
$dep_nm1_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010D') {
$dep_eb_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010EA' || $loopid == '2010EC') {
$evt_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010FA') {
$svc_html .= "<tr class='{$cls}'><td><em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
} else {
$hdr_html .= "<tr class='{$cls}'><td>{$loopid} <em><b>Rejection:</b></em></td><td colspan=3 title='{$follow}'>{$rej_reason}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('TRN' . $de, $seg, 4) === 0) {
// trace identifier
$sar = explode($de, $seg);
$elem01 = isset($sar[1]) ? $sar[1] : '';
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $sar[3] : '';
$elem04 = isset($sar[4]) ? $sar[4] : '';
//
$trctp = $elem01 == '2' ? 'Reference ' : 'Current ';
if ($loopid == '2000E') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$trctp} tracking no:</em> {$elem02} (by {$elem03} {$elem04})</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000F') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$trctp} tracking no:</em> {$elem02} (by {$elem03} {$elem04})</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('UM' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) ? $cd27x->get_271_code('UM01', $sar[1]) : '';
$elem02 = isset($sar[2]) ? $cd27x->get_271_code('UM02', $sar[2]) : '';
$elem03 = isset($sar[3]) ? $cd27x->get_271_code('EB03', $sar[3]) : '';
$elem04 = isset($sar[4]) ? $sar[4] : '';
$elem04a = '';
if (strpos($elem04, $ds)) {
$elem04_ar = explode($ds, $elem04);
if (isset($elem04_ar[1]) && $elem04_ar[1] == 'B') {
$elem04a .= isset($elem04_ar[0]) ? $cd27x->get_271_code('POS', $elem04_ar[0]) : '';
} else {
$elem04a = $elem04;
}
}
/* UM05 -- not used
$elem05 = (isset($sar[5])) ? $sar[5] : '';
$elem05a = '';
if (strpos($elem05, $ds) {
$elem05_ar = explode($ds, $elem05);
$elem05a .= (isset($elem05_ar[0])) ? $cd27x->get_271_code('POS', $elem05_ar[0]) : '';
$elem05a .= (isset($elem05_ar[1])) ? $cd27x->get_271_code('POS', $elem05_ar[1]) : '';
$elem05a .= (isset($elem05_ar[2])) ? $cd27x->get_271_code('POS', $elem05_ar[2]) : '';
$elem05a .= (isset($elem05_ar[3])) ? 'State Code: '.$elem05_ar[3] : '';
$elem05a .= (isset($elem05_ar[3])) ? 'Country Code: '.$elem05_ar[4] : '';
} else {
$elem05a .= $elem05;
}
//
* */
$elem06 = isset($sar[6]) ? $cd27x->get_271_code('UM06', $sar[6]) : '';
// UM07 UM08 not used
//$elem07 = (isset($sar[7])) ? $cd27x->get_271_code('UM07', $sar[7]) : '';
//$elem08 = (isset($sar[8])) ? $cd27x->get_271_code('UM08', $sar[8]) : '';
//
if ($loopid == '2000E') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$elem01} <em>Certification Type:</em> {$elem02}</td></tr>" . PHP_EOL;
$evt_html .= $elem03 || $elem04a || $elem06 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04a} ({$elem06})</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '2000F') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$elem01} <em>Certification Type:</em> {$elem02}</td></tr>" . PHP_EOL;
$svc_html .= $elem03 || $elem04a || $elem06 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04a} ({$elem06})</td></tr>" . PHP_EOL : "";
}
continue;
}
//
if (strncmp('HCR' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('HCR01', $sar[1]) : '';
$elem02 = isset($sar[2]) && $sar[2] ? "<em>Reference: </em>" . $sar[2] : '';
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('HCR03', $sar[3]) : '';
$elem04 = isset($sar[4]) && $sar[4] ? $cd27x->get_271_code('HCR04', $sar[4]) : '';
$elem04 = $elem04 ? "<em>2nd Surgical Opinion:</em> {$elem04}" : "";
//
if ($loopid == '2000E') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$elem01} {$elem02}</td></tr>" . PHP_EOL;
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03}</td></tr>" . PHP_EOL;
$evt_html .= $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem04}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '2000F') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$elem01} {$elem02}</td></tr>" . PHP_EOL;
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03}</td></tr>" . PHP_EOL;
$svc_html .= $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem04}</td></tr>" . PHP_EOL : "";
}
//
continue;
}
//
if (strncmp('REF' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) ? $cd27x->get_271_code('REF', $sar[1]) : '';
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $sar[2] : '';
//
if ($loopid == '2010B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010D') {
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000E') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010E') {
$evt_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000F') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010FA') {
$svc_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('DMG' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$elem02 = isset($sar[2]) && $sar[2] ? edih_format_date($sar[2]) : "";
if (isset($sar[3]) && $sar[3]) {
if ($sar[3] == 'M') {
$elem03 = "Male";
} elseif ($sar[3] == 'F') {
$elem03 = "Female";
} else {
$elem03 = "Unknown";
}
}
if ($loopid == '2010C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td>{$elem03}</td><td colspan=2><em>Date of Birth</em> {$elem02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010D') {
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td>{$elem03}</td><td colspan=2><em>Date of Birth</em> {$elem02}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('INS' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
$elem01 = isset($sar[1]) && $sar[1] == 'Y' ? "Subscriber" : "Dependent";
$elem02 = isset($sar[2]) && $sar[2] ? $cd27x->get_271_code('INS02', $sar[2]) : "";
$elem03 = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$elem04 = isset($sar[4]) && $sar[4] == '25' ? "<b>Information changed</b>" : "";
$elem17 = isset($sar[17]) && $sar[17] ? $sar[17] : "";
//
if ($loopid == '2010C') {
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td>{$elem01} {$elem17}</td><td>{$elem02}</td><td>{$elem03} {$elem04}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2010D') {
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td>{$elem01} {$elem17}</td><td>{$elem02}</td><td>{$elem03} {$elem04}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('DTP' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
$var = '';
$elem01 = isset($sar[1]) ? $sar[1] : '';
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $sar[3] : '';
//
$idtype = $elem01 ? $cd27x->get_271_code('DTP', $elem01) : "";
if ($elem02 == 'D8' && $elem03) {
$var = edih_format_date($elem03);
} elseif ($elem02 == 'RD8' && $elem03) {
$var = edih_format_date(substr($elem03, 0, 8));
$var .= ' - ' . edih_format_date(substr($elem03, -8));
}
if ($loopid == '2000E') {
$evt_html .= "<tr class='{$cls}'><td>></td><td>{$idtype}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2000F') {
$svc_html .= "<tr class='{$cls}'><td>></td><td>{$idtype}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
}
continue;
}
//
if (strncmp('HI' . $de, $seg, 3) === 0) {
// This is the Health Care Information Codes segment
// -- to give all information in the segment, we need to
// lookup all the code values ICD-9, ICD-10, LOINC, DRG, etc.
// -- At this time, give the code source and code, with dates if any
//
$sar = explode($de, $seg);
//
$hi_str = '';
$tr_str = '';
foreach ($sar as $hi) {
if (strpos($hi, $ds)) {
$a = explode($ds, $hi);
$hi_str .= isset($a[0]) && $a[0] ? $cd27x->get_271_code('HI01', $a[0]) : "";
$hi_str .= isset($a[1]) && $a[1] ? '[ ' . $a[1] . ' ]' : '[]';
if (isset($a[2]) && isset($a[3])) {
$hi_str .= $a[2] == 'D8' ? ' ' . edih_format_date($a[3]) : '';
$hi_str .= $a[2] == 'RD8' ? edih_format_date(substr($a[3], 0, 8)) : "";
$hi_str .= $a[2] == 'RD8' ? edih_format_date(substr($a[3], -8)) : "";
}
} else {
$hi_str .= $hi . ' ';
}
$tr_str .= "<tr class='{$cls}'><td><em>Codes</em></td><td colspan=3>{$hi_str}</td></tr>" . PHP_EOL;
}
//
if ($loopid == '2000E') {
$evt_html .= $tr_str;
} elseif ($loopid == '2000F') {
$svc_html .= $tr_str;
}
//
continue;
}
//
if (strncmp('HSD' . $de, $seg, 4) === 0) {
// Health Care Services Delivery
$sar = explode($de, $seg);
//
$id = "Services Delivery";
$tr_str = '';
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('HSD01', $sar[1]) : '';
// quantity qualifier
$elem02 = isset($sar[2]) && $sar[2] ? $sar[2] : '';
// numeric quantity
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('HSD01', $sar[3]) : '';
// measurement unit
$elem04 = isset($sar[4]) && $sar[4] ? $sar[4] : '';
// sample selection modulus
$elem05 = isset($sar[5]) && $sar[5] ? $cd27x->get_271_code('EB06', $sar[5]) : '';
// time period qualifier
$elem06 = isset($sar[6]) && $sar[6] ? $sar[6] : '';
// number of periods
$elem07 = isset($sar[7]) && $sar[7] ? $cd27x->get_271_code('HSD07', $sar[7]) : '';
// delivery
$elem08 = isset($sar[8]) && $sar[8] ? $cd27x->get_271_code('HSD08', $sar[8]) : '';
// delivery
//
if (($elem01 || $elem02) && !$elem08) {
$tr_str .= $elem03 && $elem04 && $elem06 ? "<tr class='{$cls}'><td><em>{$id}</em></td><td colspan=3>{$elem02} {$elem01} per every {$elem04} {$elem03} for {$elem06} {$elem05} {$elem07}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem03 && $elem04 && !$elem06 ? "<tr class='{$cls}'><td><em>{$id}</em></td><td colspan=3>{$elem02} {$elem01} per every {$elem04} {$elem03} {$elem07}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem03 && !$elem04 && $elem06 ? "<tr class='{$cls}'><td><em>{$id}</em></td><td colspan=3>{$elem02} {$elem01} for {$elem06} {$elem05} {$elem07}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem03 && !$elem04 && !$elem06 ? "<tr class='{$cls}'><td><em>{$id}</em></td><td colspan=3>{$elem02} {$elem01} {$elem07}</td></tr>" . PHP_EOL : "";
} else {
$tr_str .= "<tr class='{$cls}'><td><em>{$id}</em></td><td colspan=3>{$elem02} {$elem01} {$elem07} {$elem08}</td></tr>" . PHP_EOL;
}
//
if ($loopid == '2000E') {
$evt_html .= $tr_str;
} elseif ($loopid == '2000F') {
$svc_html .= $tr_str;
}
continue;
}
//
if (strncmp('CRC' . $de, $seg, 4) === 0) {
// Certification
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('CRC01', $sar[1]) : '';
// certification type code
$elem02 = isset($sar[2]) && $sar[2] ? $cd27x->get_271_code('HCR04', $sar[2]) : '';
// condition indicater
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('CRC03', $sar[3]) : '';
// condition descripter
$elem04 = isset($sar[4]) && $sar[4] ? $cd27x->get_271_code('CRC03', $sar[4]) : '';
// condition descripter
$elem05 = isset($sar[5]) && $sar[5] ? $cd27x->get_271_code('CRC03', $sar[5]) : '';
// condition descripter
$elem06 = isset($sar[6]) && $sar[6] ? $cd27x->get_271_code('CRC03', $sar[6]) : '';
// condition descripter
$elem07 = isset($sar[7]) && $sar[7] ? $cd27x->get_271_code('CRC03', $sar[7]) : '';
// condition descripter
//
$evt_html .= $elem01 ? "<tr class='{$cls}'><td><em>{$elem01}</em></td><td colspan=3><em>Conditions Apply:</em> {$elem02}</td></tr>" . PHP_EOL : "";
$evt_html .= $elem03 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03}</td></tr>" . PHP_EOL : "";
$evt_html .= $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem04}</td></tr>" . PHP_EOL : "";
$evt_html .= $elem05 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem05}</td></tr>" . PHP_EOL : "";
$evt_html .= $elem06 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem06}</td></tr>" . PHP_EOL : "";
$evt_html .= $elem07 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem07}</td></tr>" . PHP_EOL : "";
//
continue;
}
//
if (strncmp('CL1' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
//
$tr_str = '';
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('CL101', $sar[1]) : '';
// admission type code
$elem02 = isset($sar[2]) && $sar[2] ? $cd27x->get_271_code('CL102', $sar[2]) : '';
// admission source code
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('CL103', $sar[3]) : '';
// patient status code
//
$tr_str .= "<tr class='{$cls}'><td><em>Hospital</em> </td><td colspan=3>{$elem01} {$elem02}</td></tr>" . PHP_EOL;
$tr_str .= $elem03 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03}</td></tr>" . PHP_EOL : "";
//
if ($loopid == '2000E') {
$evt_html .= $tr_str;
} elseif ($loopid == '2000F') {
$svc_html .= $tr_str;
}
continue;
}
//
if (strncmp('CR1' . $de, $seg, 4) === 0) {
// ambulance
$sar = explode($de, $seg);
//
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('CR103', $sar[3]) : '';
// ambulance transit code
if (isset($sar[5])) {
if ($sar[5] == 'DH') {
$elem05 = "miles";
} elseif ($sar[5] == 'DK') {
$elem05 = "kilometers";
} else {
$elem05 = "";
}
} else {
$elem05 = "";
}
$elem06 = isset($sar[6]) ? $sar[6] : "";
//
$evt_html .= "<tr class='{$cls}'><td><em>Ambulance:</em></td><td colspan=3>{$elem03} {$elem06} {$elem05}</td></tr>" . PHP_EOL;
//
continue;
}
//
if (strncmp('CR2' . $de, $seg, 4) === 0) {
// spinal manipulation
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) && $sar[1] ? $sar[1] : "";
$elem02 = isset($sar[2]) && $sar[2] ? $sar[2] : "";
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('CR203', $sar[3]) : "";
// spinal code
$elem04 = isset($sar[4]) && $sar[4] ? $cd27x->get_271_code('CR203', $sar[4]) : "";
// spinal code
$elem04 = $elem04 ? "-- " . $elem04 : "";
// elem05 -- elem12 not used
//
$evt_html .= "<tr class='{$cls}'><td><em>Spinal:</em></td><td colspan=3> {$elem01} {$elem02} {$elem03} {$elem04}</td></tr>" . PHP_EOL;
//
continue;
}
//
if (strncmp('CR5' . $de, $seg, 4) === 0) {
// oxygen
$sar = explode($de, $seg);
//
$tr_str = '';
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('CR503', $sar[3]) : "";
// oxygen code
$elem04 = isset($sar[4]) && $sar[4] ? $cd27x->get_271_code('CR503', $sar[4]) : "";
// oxygen code
$elem06 = isset($sar[6]) && $sar[6] ? "Flow (lpm): " . $sar[6] : "";
$elem07 = isset($sar[7]) && $sar[7] ? "Times/day: " . $sar[7] : "";
$elem08 = isset($sar[8]) && $sar[8] ? "Hours: " . $sar[8] : "";
$elem09 = isset($sar[9]) && $sar[9] ? $sar[9] : "";
$elem16 = isset($sar[16]) && $sar[16] ? "Flow (lpm): " . $sar[16] : "";
$elem17 = isset($sar[17]) && $sar[17] ? $cd27x->get_271_code('CR517', $sar[17]) : "";
$elem18 = isset($sar[18]) && $sar[18] ? $cd27x->get_271_code('CR503', $sar[18]) : "";
//
$title = "Descriptors and Rates/times per edi guide. <b>Do not rely on these!</b>" . PHP_EOL;
$t2 = "Descriptors per edi companion guide. <b>Do not rely on these!</b>" . PHP_EOL;
//
$tr_str .= "<tr class='{$cls}'><td><em>Oxygen</em></td><td colspan=3><b>You must independently verify this information!</b></td></tr>" . PHP_EOL;
$tr_str .= "<tr class='{$cls}'><td>></td><td colspan=3>{$title}</td></tr>" . PHP_EOL;
$tr_str .= $elem03 || $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3 title='{$t2}'><em>Equipment Type: </em>{$elem03} {$elem04}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem06 || $elem07 || $elem08 ? "<tr class='{$cls}'><td>></td><td colspan=3 title='{$title}'>{$elem06} {$elem07} {$elem08}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem09 ? "<tr class='{$cls}'><td>></td><td colspan=3><em>Therapist: </em>{$elem09}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem16 ? "<tr class='{$cls}'><td>></td><td colspan=3 title='{$title}'>{$elem16}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem17 ? "<tr class='{$cls}'><td>></td><td colspan=3 title='{$t2}'><em>Delivery: </em>{$elem17}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem18 ? "<tr class='{$cls}'><td>></td><td colspan=3 title='{$t2}'><em>Equipment Type: </em>{$elem18}</td></tr>" . PHP_EOL : "";
//
$evt_html .= $tr_str;
//
continue;
}
//
if (strncmp('CR6' . $de, $seg, 4) === 0) {
// oxygen
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('UM07', $sar[1]) : "";
// patient condition code
$elem02 = isset($sar[2]) && $sar[2] ? edih_format_date($sar[2]) : "";
// HH start date
$elem03 = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$elem04 = isset($sar[4]) && $sar[4] ? $sar[4] : "";
if ($elem03 == 'D8' && $elem04) {
$elem04 = edih_format_date($elem04);
} elseif ($elem03 == 'RD8' && $elem04) {
$var = edih_format_date(substr($dtp03, 0, 8));
$elem04 = $var . ' - ' . edih_format_date(substr($elem04, -8));
}
$elem07 = isset($sar[7]) && $sar[7] ? $cd27x->get_271_code('HCR04', $sar[8]) : "";
$elem08 = isset($sar[8]) && $sar[8] ? $cd27x->get_271_code('CR608', $sar[8]) : "";
// certification type code
//
$evt_html .= "<tr class='{$cls}'><td><em>Home Health</em></td><td><em>HH Began</em> {$elem02}</td><td colspan=2>{$elem01}</td></tr>" . PHP_EOL;
$evt_html .= $elem03 || $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=2><em>Period</em> {$elem04}</td><td>(MCR) {$elem07}</td></tr>" . PHP_EOL : "";
$evt_html .= $elem08 ? "<tr class='{$cls}'><td>></td><td colspan=2><em>Period</em> {$elem08}</td><td>(MCR) {$elem05}</td></tr>" . PHP_EOL : "";
//
continue;
}
//
if (strncmp('PWK' . $de, $seg, 4) === 0) {
// paperwork
$sar = explode($de, $seg);
//
$tr_str = '';
//
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('PWK01', $sar[1]) : "";
// paperwork code
$elem02 = isset($sar[2]) && $sar[2] ? $cd27x->get_271_code('PWK02', $sar[2]) : "";
// delivery code
$elem05 = isset($sar[5]) && $sar[5] == 'AC' ? "Attachment Control Number" : "";
$elem06 = isset($sar[6]) && $sar[6] ? $sar[6] : "";
$elem07 = isset($sar[7]) && $sar[7] ? $sar[7] : "";
//
$tr_str .= "<tr class='{$cls}'><td><em>Paperwork</em></td><td colspan=3>{$elem01} {$elem02}</td></tr>" . PHP_EOL;
$tr_str .= $elem05 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem05} {$elem06}</td></tr>" . PHP_EOL : "";
$tr_str .= $elem07 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem07}</td></tr>" . PHP_EOL : "";
//
if ($loopid == '2000E') {
$evt_html .= $tr_str;
} elseif ($loopid == '2000F') {
$svc_html .= $tr_str;
}
continue;
}
//
if (strncmp('MSG' . $de, $seg, 4) === 0) {
// paperwork
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) && $sar[1] ? $sar[1] : "";
//
if ($loopid == '2000E') {
$evt_html .= $elem01 ? "<tr class='{$cls}'><td><em>Message</em></td><td colspan=3>{$elem01}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '2000F') {
$svc_html .= $elem01 ? "<tr class='{$cls}'><td><em>Message</em></td><td colspan=3>{$elem01}</td></tr>" . PHP_EOL : "";
}
continue;
}
//
if (strncmp('SV1' . $de, $seg, 4) === 0) {
// professional services
$sar = explode($de, $seg);
//
$elem01 = '';
if (isset($sar[1]) && strpos($sar[1], $ds)) {
$ar01 = explode($ds, $sar[1]);
$ct = count($ar01);
$elem01 = isset($ar01[0]) && $ar01[0] ? $cd27x->get_271_code('SV101', $ar01[0]) : "";
//
if ($ct == 8) {
$ct = 7;
$elem01 .= " " . $ar01[1] . " -- " . $ar01[8];
} else {
$elem01 .= " " . $ar01[1];
}
if ($elem01 && $ct > 2) {
for ($i = 2; $i < $ct; $i++) {
$elem01 .= ' ' . $ar01[$i];
}
}
} elseif (isset($sar[1]) && $sar[1]) {
$elem01 = $sar[1];
}
$elem02 = isset($sar[2]) && $sar[2] ? edih_format_money($sar[2]) : "";
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('SV103', $sar[3]) : "";
$elem04 = isset($sar[4]) && $sar[4] ? $sar[4] : "";
$elem11 = isset($sar[11]) && $sar[11] ? $cd27x->get_271_code('HCR04', $sar[11]) : "";
$elem20 = isset($sar[20]) && $sar[20] ? $cd27x->get_271_code('SV120', $sar[20]) : "";
//
$elem11 = $elem11 ? "<em>EPSDT</em> " . $elem11 : "";
//
$svc_html .= $elem01 ? "<tr class='{$cls}'><td><em>Professional Svc</em></td><td colspan=3>{$elem01} {$elem02}</td></tr>" . PHP_EOL : "";
$svc_html .= $elem03 || $elem04 || $elem11 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04} {$elem11}</td></tr>" . PHP_EOL : "";
$svc_html .= $elem20 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem20}</td></tr>" . PHP_EOL : "";
//
continue;
}
//
if (strncmp('SV2' . $de, $seg, 4) === 0) {
// paperwork
$sar = explode($de, $seg);
//
$elem01 = '';
if (isset($sar[1]) && strpos($sar[1], $ds)) {
$ar01 = explode($ds, $sar[1]);
$ct = count($ar01);
$elem01 = isset($ar01[0]) && $ar01[0] ? $cd27x->get_271_code('SV101', $ar01[0]) : "";
//
if ($ct == 8) {
$ct = 7;
$elem01 .= " " . $ar01[1] . " -- " . $ar01[8];
} else {
$elem01 .= " " . $ar01[1];
}
if ($elem01 && count($ar01) > 2) {
for ($i = 2; $i < $ct; $i++) {
$elem01 .= ' ' . $ar01[$i];
}
}
} elseif (isset($sar[1]) && $sar[1]) {
$elem01 = $sar[1];
}
$elem02 = isset($sar[2]) && $sar[2] ? edih_format_money($sar[2]) : "";
$elem03 = isset($sar[3]) && $sar[3] ? $cd27x->get_271_code('SV103', $ar01[3]) : "";
$elem04 = isset($sar[4]) && $sar[4] ? $sar[4] : "";
$elem05 = isset($sar[5]) && $sar[5] ? $sar[5] : "";
$elem06 = isset($sar[6]) && $sar[6] ? edih_format_money($sar[6]) : "";
$elem10 = isset($sar[20]) && $sar[20] ? $cd27x->get_271_code('SV120', $ar01[20]) : "";
//
$svc_html .= $elem01 ? "<tr class='{$cls}'><td><em>Inst Service</em></td><td colspan=3>{$elem01} {$elem02}</td></tr>" . PHP_EOL : "";
$svc_html .= $elem03 || $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04} {$elem05} {$elem06}</td></tr>" . PHP_EOL : "";
$svc_html .= $elem10 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem10}</td></tr>" . PHP_EOL : "";
//
continue;
}
}
//
$str_html .= $hdr_html;
$str_html .= $src_html ? $src_html : "";
$str_html .= $rcv_html ? $rcv_html : "";
$str_html .= $sbr_nm1_html ? $sbr_nm1_html : "";
$str_html .= $dep_nm1_html ? $dep_nm1_html : "";
$str_html .= $evt_html ? $evt_html : "";
$str_html .= $svc_html ? $svc_html : "";
$str_html .= "<tr><td colspan=4> </td></tr>" . PHP_EOL;
$str_html .= "</tbody>" . PHP_EOL . "</table>" . PHP_EOL;
}
//
return $str_html;
}
/**
* Produce an html display of information in
* the x12 edi 271 eligibility report for a particular patient
*
* @uses edih_271_codes()
* @uses edih_format_money()
* @uses edih_format_date()
* @uses edih_format_percent()
*
* @param object edih_x12_file type 271
* @param string bht03 or clm01 reference for transaction
* @return string
*/
function edih_277_transaction_html($obj277, $bht03, $accordion = false)
{
// get the transaction segments
$trans = $obj277->edih_x12_transaction($bht03);
// get other necessary items
$de = $obj277->edih_delimiters()['e'];
$ds = $obj277->edih_delimiters()['s'];
$dr = $obj277->edih_delimiters()['r'];
$fn = $obj277->edih_filename();
//
if (!is_array($trans) || !count($trans)) {
$str_html = "<p>Did not find transaction {$bht03} in {$fn}</p>" . PHP_EOL;
return $str_html;
}
//
$cd27x = new edih_271_codes($ds, $dr);
//
$h3_lbl = '';
$str_html = "";
$hdr_html = "";
//
$hdr_html = "<table id={$bht03} class='h277' columns=4>";
$hdr_html .= "<caption>Claim Status</caption>" . PHP_EOL;
$hdr_html .= "<thead>" . PHP_EOL;
$hdr_html .= "<tr><th>Reference</th><th>Information</th><th colspan=2>{$fn}</th></tr>" . PHP_EOL;
//
$hdr_html .= "</thead>" . PHP_EOL . "<tbody>" . PHP_EOL;
//
$src_html = "";
$rcv_html = "";
$prv_html = "";
$sbr_nm1_html = "";
$dep_nm1_html = "";
$sbr_stc_html = "";
$dep_stc_html = "";
//
$trns_ct = count($trans);
for ($i = 0; $i < $trns_ct; $i++) {
foreach ($trans[$i] as $seg) {
//
$idtype = '';
$name = '';
$var = '';
$rej_reason = '';
$follow = '';
$addr = '';
// debug
// echo "$i loop: $loopid Segment: $seg".PHP_EOL;
//
if (strncmp('BHT' . $de, $seg, 4) === 0) {
$loopid = 'Heading';
$sar = explode($de, $seg);
if (isset($sar[1])) {
if ($sar[1] == '0010') {
$elem01 = "Src, Rcv, Prv, Sbr, Dep";
} elseif ($sar[1] == '0085') {
$elem01 = "Src, Rcv, Prv, Pt";
} else {
$elem01 = "Not determined ({$sar[1]})";
}
} else {
$elem01 = '';
}
//
$elem02 = isset($sar[2]) && $sar[2] !== false ? $cd27x->get_271_code('BHT02', $sar[2]) : "";
$elem03 = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$elem04 = isset($sar[4]) && $sar[4] ? edih_format_date($sar[4]) : "";
$elem06 = isset($sar[6]) && $sar[6] ? $cd27x->get_271_code('BHT06', $sar[6]) : "";
//
$hdr_html .= "<tr><td colspan=2><em>Reference:</em> {$elem03}</td><td colspan=2><em>Sequence:</em> {$elem01}</td></tr>" . PHP_EOL;
$hdr_html .= "<tr><td colspan=2><em>Date:</em> {$elem04}</td><td colspan=2><em>Type:</em> {$elem02}</td>" . PHP_EOL;
$hdr_html .= $elem06 ? "<tr><td>></td><td colspan=3><em>Type:</em> {$elem06}</td></tr>" . PHP_EOL : "";
//
$bht = $elem03;
continue;
}
//
if (strncmp('HL' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
$elem03 = isset($sar[3]) ? $sar[3] : "";
if ($elem03 == '20') {
// level code
$loopid = '2000A';
// info source (payer)
$cls = "src";
$src_html .= "<tr class='{$cls}'><td colspan=4><b>Information Source</b></td></tr>" . PHP_EOL;
} elseif ($elem03 == '21') {
$loopid = '2000B';
// info receiver (clinic)
$cls = "rcv";
$rcv_html .= "<tr class='{$cls}'><td colspan=4><b>Information Receiver</b></td></tr>" . PHP_EOL;
} elseif ($elem03 == '19') {
$loopid = '2000C';
// provider
$cls = "prv";
$has_eb = false;
$prv_html .= "<tr class='{$cls}'><td colspan=4><b>Provider</b></td></tr>" . PHP_EOL;
} elseif ($elem03 == '22') {
$loopid = '2000D';
// subscriber
$cls = "sbr";
$sbr_nm1_html .= "<tr class='{$cls}'><td colspan=4><b>Subscriber</b></td></tr>" . PHP_EOL;
} elseif ($elem03 == 'PT') {
$loopid = '2000D';
// patient in 277CA
$cls = "sbr";
$sbr_nm1_html .= "<tr class='{$cls}'><td colspan=4><b>Patient</b></td></tr>" . PHP_EOL;
} elseif ($elem03 == '23') {
$loopid = '2000E';
// dependent
$cls = "dep";
$dep_nm1_html .= "<tr class='{$cls}'><td colspan=4><b>Dependent</b></td></tr>" . PHP_EOL;
} else {
csv_edihist_log("edih_277_transaction_html: HL segment error {$fn}");
}
//
$qtystr = '';
// reset for QTY and AMT segments in 277CA
continue;
}
//
if (strncmp('NM1' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$nm101 = isset($sar[1]) ? $sar[1] : '';
$descr = $nm101 ? $cd27x->get_271_code('NM101', $nm101) : "";
//
$name = isset($sar[3]) && $sar[3] ? $sar[3] : "";
$name .= isset($sar[7]) && $sar[7] ? " {$sar[7]}" : "";
$name .= isset($sar[4]) && $sar[4] ? ", {$sar[4]}" : "";
$name .= isset($sar[5]) && $sar[5] ? " {$sar[5]}" : "";
$nm109 = isset($sar[9]) && $sar[9] ? $sar[9] : "";
//
$nm108 = isset($sar[8]) && $sar[8] ? $cd27x->get_271_code('NM108', $sar[8]) : "";
//
if ($loopid == '2000A') {
$src_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$src_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'><em>{$nm108}</em> {$nm109}</td></tr>" . PHP_EOL;
$loopid = '2100A';
} elseif ($loopid == '2000B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'><em>{$nm108}</em> {$nm109}</td></tr>" . PHP_EOL;
$loopid = '2100B';
} elseif ($loopid == '2000C') {
$prv_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$prv_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'><em>{$nm108}</em> {$nm109}</td></tr>" . PHP_EOL;
$loopid = '2100C';
} elseif ($loopid == '2000D') {
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$sbr_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'><em>{$nm108}</em> {$nm109}</td></tr>" . PHP_EOL;
$h3_lbl = $name;
$loopid = '2100D';
} elseif ($loopid == '2000E') {
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'>{$name}</td></tr>" . PHP_EOL;
$dep_nm1_html .= "<tr class='{$cls}'><td>></td><td colspan=3 title='{$descr}'><em>{$nm108}</em> {$nm109}</td></tr>" . PHP_EOL;
$h3_lbl = $name;
$loopid = '2100E';
}
//
continue;
}
// //
if (strncmp('PER' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) ? $sar[1] : '';
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $cd27x->get_271_code('PER03', $sar[3]) : "";
$elem04 = isset($sar[4]) ? $sar[4] : '';
$elem05 = isset($sar[5]) ? $cd27x->get_271_code('PER03', $sar[5]) : "";
$elem06 = isset($sar[6]) ? $sar[6] : '';
$elem07 = isset($sar[7]) ? $cd27x->get_271_code('PER03', $sar[7]) : "";
$elem08 = isset($sar[8]) ? $sar[8] : '';
$elem09 = isset($sar[9]) ? $sar[9] : '';
//
if ($loopid == '2100A') {
$src_html .= "<tr class='{$cls}'><td colspan=2>{$elem02}</td><td colspan=2 title='{$elem03} {$elem05} {$elem07}'>{$elem04} {$elem06} {$elem08}</td></tr>" . PHP_EOL;
} else {
csv_edihist_log('edih_277_html: PER segment not in 2100A loop ' . $fn);
}
//
continue;
}
//
if (strncmp('TRN' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$elem01 = isset($sar[1]) && $sar[1] == "1" ? "Transaction Ref" : "Trace";
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $sar[3] : '';
$elem04 = isset($sar[4]) ? $sar[4] : '';
//
if ($loopid == '2100B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$elem01}</em> {$elem02}</td></tr>" . PHP_EOL;
$loopid = '2200B';
} elseif ($loopid == '2100C') {
$prv_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$elem01}</em> {$elem02}</td></tr>" . PHP_EOL;
$loopid = '2200C';
} elseif ($loopid == '2100D') {
$sbr_stc_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$elem01}</em> {$elem02}</td></tr>" . PHP_EOL;
$h3_lbl = $h3_lbl ? $h3_lbl . ' ' . $elem02 : $h3_lbl;
$loopid = '2200D';
} elseif ($loopid == '2100E') {
$dep_stc_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$elem01}</em> {$elem02}</td></tr>" . PHP_EOL;
$h3_lbl = $h3_lbl ? $h3_lbl . ' ' . $elem02 : $h3_lbl;
$loopid = '2200E';
}
//
continue;
}
//
if (strncmp('STC' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
if (isset($sar[1])) {
if (strpos($sar[1], $ds)) {
// claim status category : claim status : entity identifier
$scda = explode($ds, $sar[1]);
$sc101 = isset($scda[0]) && $scda[0] ? $cd27x->get_271_code('HCCSCC', $scda[0]) : "";
$sc102 = isset($scda[1]) && $scda[1] ? $cd27x->get_271_code('HCCSC', $scda[1]) : "";
$sc103 = isset($scda[2]) && $scda[2] ? $cd27x->get_271_code('NM101', $scda[2]) : "";
}
} else {
$stc01 = $sar[1];
}
$stc02 = isset($sar[2]) && $sar[2] ? edih_format_date($sar[2]) : "";
// status information date
$stc03 = "";
// action code
if (isset($sar[3])) {
if ($sar[3] == 'WQ') {
$stc03 = "Accepted";
} elseif ($sar[3] == 'F') {
$stc03 = "Final";
} elseif ($sar[3] == '15') {
$stc03 = "Correct/Resubmit";
} elseif ($sar[3] == 'U') {
$stc03 = "Rejected";
} else {
$stc03 = $sar[3];
}
}
$stc04 = isset($sar[4]) && $sar[4] ? edih_format_money($sar[4]) : "";
// billed amount
$stc05 = isset($sar[5]) && $sar[5] ? edih_format_money($sar[5]) : "";
// paid amount
$stc06 = isset($sar[6]) && $sar[6] ? edih_format_date($sar[6]) : "";
// payment date
//$stc07 not used
$stc08 = isset($sar[8]) && $sar[8] ? edih_format_date($sar[8]) : "";
// check issue date
$stc09 = isset($sar[9]) && $sar[9] ? $sar[9] : "";
// check or eft number
//
$stc10 = "";
if (isset($sar[10]) && $sar[10]) {
// claim status category : claim status : entity identifier
if (strpos($sar[10], $ds)) {
$scda = explode($ds, $sar[1]);
$sc201 = isset($scda[0]) && $scda[0] ? $cd27x->get_271_code('HCCSCC', $scda[0]) : "";
$sc202 = isset($scda[1]) && $scda[1] ? $cd27x->get_271_code('HCCSC', $scda[1]) : "";
$sc203 = isset($scda[2]) && $scda[2] ? $cd27x->get_271_code('NM101', $scda[2]) : "";
$sc204 = isset($scda[3]) && ($scda[3] = 'RA') ? "Rx Reject/Payment Codes" : "";
} else {
$stc10 = $sar[10];
}
}
//
$stc11 = "";
if (isset($sar[11]) && $sar[11]) {
// claim status category : claim status : entity identifier
if (strpos($sar[10], $ds)) {
$scda = explode($ds, $sar[1]);
$sc301 = isset($scda[0]) && $scda[0] ? $cd27x->get_271_code('HCCSCC', $scda[0]) : "";
$sc302 = isset($scda[1]) && $scda[1] ? $cd27x->get_271_code('HCCSC', $scda[1]) : "";
$sc303 = isset($scda[2]) && $scda[2] ? $cd27x->get_271_code('NM101', $scda[2]) : "";
$sc304 = isset($scda[3]) && ($scda[3] = 'RA') ? "Rx Reject/Payment Codes" : "";
} else {
$stc11 = $sar[10];
}
}
//
$stc12 = isset($sar[12]) && $sar[12] ? $sar[12] : "";
// message
//
$stc_html = isset($sc101) ? "<tr class='{$cls}'><td>{$stc03}</td><td colspan=2>{$sc101}</td><td>{$stc02} {$stc04}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc102) ? "<tr class='{$cls}'><td>></td><td colspan=3>{$sc102}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc103) && $sc103 ? "<tr class='{$cls}'><td>></td><td colspan=3><em>Entity</em> {$sc103}</td></tr>" . PHP_EOL : "";
$stc_html .= $stc05 || $stc06 || $stc08 || $stc09 ? "<tr class='{$cls}'><td><em>Payment</em></td><td colspan=3>{$stc05} {$stc06} {$stc08} {$stc09}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc201) ? "<tr class='{$cls}'><td>></td><td colspan=3>{$sc201} {$sc204}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc202) ? "<tr class='{$cls}'><td>></td><td colspan=3>{$sc202}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc203) && $sc203 ? "<tr class='{$cls}'><td>></td><td colspan=3><em>Entity</em> {$sc203}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc301) ? "<tr class='{$cls}'><td>></td><td colspan=3>{$sc301} {$sc304}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc302) ? "<tr class='{$cls}'><td>></td><td colspan=3>{$sc302}</td></tr>" . PHP_EOL : "";
$stc_html .= isset($sc303) && $sc303 ? "<tr class='{$cls}'><td>></td><td colspan=3><em>Entity</em> {$sc303}</td></tr>" . PHP_EOL : "";
$stc_html .= $stc12 ? "<tr class='{$cls}'><td><em>Message</em></td><td colspan=3>{$stc12}</td></tr>" . PHP_EOL : "";
//
if ($loopid == '2200B') {
$rcv_html .= $stc_html;
} elseif ($loopid == '2200C') {
$prv_html .= $stc_html;
} elseif ($loopid == '2200D') {
$sbr_stc_html .= $stc_html;
} elseif ($loopid == '2200E') {
$dep_stc_html .= $stc_html;
}
//
continue;
}
// in 277CA, expect QTY followed by AMT
// do not expect QTY or AMT in regular 277
if (strncmp('QTY' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
if (isset($sar[1])) {
if ($sar[1] == '90') {
$qtystr = "Acknowledged Quantity ";
} elseif ($sar[1] == 'AA') {
$qtystr = "Unacknowledged Quantity ";
} elseif ($sar[1] == 'QA') {
$qtystr = "Quantity Approved ";
} elseif ($sar[1] == 'QC') {
$qtystr = "Quantity Disapproved ";
} else {
$qtystr = "Quantity ";
}
} else {
$qtystr = "";
}
$qtystr .= isset($sar[2]) && $sar[2] ? $sar[2] : "";
}
//
if (strncmp('AMT' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
// 277CA
$amtstr = isset($sar[1]) && $sar[1] == 'YU' ? "Amt " : "Amt Rej ";
$amtstr .= isset($sar[2]) && $sar[2] ? edih_format_money($sar[2]) : "";
//
if ($loopid == '2200B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$qtystr} {$amtstr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200C') {
$prv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$qtystr} {$amtstr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200D') {
$sbr_stc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$qtystr} {$amtstr}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200E') {
$dep_stc_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$qtystr} {$amtstr}</td></tr>" . PHP_EOL;
}
$amtstr = '';
$qtystr = '';
//
continue;
}
//
if (strncmp('REF' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
//
$elem01 = isset($sar[1]) ? $cd27x->get_271_code('REF', $sar[1]) : '';
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $sar[2] : '';
//
if ($loopid == '2200B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200C') {
$prv_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200D' || $loopid == '2220D') {
$sbr_stc_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200E' || $loopid == '2220E') {
$dep_stc_html .= "<tr class='{$cls}'><td>></td><td colspan=2><em>{$elem01}</em> {$elem02}</td><td>{$elem03}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('DTP' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
$var = '';
//
$elem01 = isset($sar[1]) && $sar[1] ? $cd27x->get_271_code('DTP', $sar[1]) : "";
$elem02 = isset($sar[2]) ? $sar[2] : '';
$elem03 = isset($sar[3]) ? $sar[3] : '';
//
$idtype = $elem01 ? $cd27x->get_271_code('DTP', $elem01) : "";
if ($elem02 == 'D8' && $elem03) {
$var = edih_format_date($elem03);
} elseif ($elem02 == 'RD8' && $elem03) {
$var = edih_format_date(substr($elem03, 0, 8));
$var .= ' - ' . edih_format_date(substr($elem03, -8));
}
//
if ($loopid == '2200D' || $loopid == '2220D') {
$sbr_stc_html .= "<tr class='{$cls}'><td>></td><td>{$elem01}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2200E' || $loopid == '2220E') {
$dep_stc_html .= "<tr class='{$cls}'><td>></td><td>{$elem01}</td><td colspan=2>{$var}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('SVC' . $de, $seg, 4) === 0) {
//
$sar = explode($de, $seg);
//
$elem01 = '';
// composite procedure code source:code:modifier:modifier
if (isset($sar[1]) && $sar[1]) {
// construct a code source code modifier string
if (strpos($sar[1], $ds)) {
$scda = explode($ds, $sar[1]);
reset($scda);
while (list($key, $val) = each($scda)) {
if ($key == 0 && $val) {
$elem01 = $cd27x->get_271_code('EB13', $val);
} else {
$elem01 .= " " . $val;
}
}
} else {
$elem01 = $sar[1];
}
}
//
$elem02 = isset($sar[2]) && $sar[2] ? edih_format_money($sar[2]) : "";
// billed amount
$elem03 = isset($sar[3]) && $sar[3] ? edih_format_money($sar[3]) : "";
// paid amount
$elem04 = isset($sar[4]) && $sar[4] ? $sar[4] : "";
// revenue code
$elem05 = isset($sar[5]) && $sar[5] ? $sar[5] : "";
// quantity
// $elem06 not used
$elem07 = isset($sar[7]) && $sar[7] ? $sar[7] : "";
// original unis of service
//
if ($loopid == '2200B') {
$rcv_html .= "<tr class='{$cls}'><td><em>Service</em></td><td>{$elem01}</td><td>{$elem02}</td><td>{$elem04}</td></tr>" . PHP_EOL;
$rcv_html .= $elem03 || $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '2200D' || $loopid == '2220D') {
$sbr_stc_html .= "<tr class='{$cls}'><td><em>Service</em></td><td>{$elem01}</td><td colspan=2>{$elem02} {$elem04}</td></tr>" . PHP_EOL;
$sbr_stc_html .= $elem03 || $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '2200E' || $loopid == '2220E') {
$dep_stc_html .= "<tr class='{$cls}'><td><em>Service</em></td><td>{$elem01}</td><td colspan=2>{$elem02} {$elem04}</td></tr>" . PHP_EOL;
$dep_stc_html .= $elem03 || $elem04 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$elem03} {$elem04}</td></tr>" . PHP_EOL : "";
}
//
continue;
}
//
}
//
if ($accordion) {
$str_html .= "<h3>{$bht} {$h3_lbl}</h3>" . PHP_EOL;
$str_html .= "<div id='ac_{$bht}'>" . PHP_EOL;
}
$str_html .= $hdr_html ? $hdr_html : "";
$str_html .= $src_html ? $src_html : "";
$str_html .= $rcv_html ? $rcv_html : "";
$str_html .= $prv_html ? $prv_html : "";
$str_html .= $sbr_nm1_html ? $sbr_nm1_html : "";
$str_html .= $sbr_stc_html ? $sbr_stc_html : "";
$str_html .= $dep_nm1_html ? $dep_nm1_html : "";
$str_html .= $dep_stc_html ? $dep_stc_html : "";
$str_html .= "<tr><td colspan=4> </td></tr>" . PHP_EOL;
$str_html .= "</tbody>" . PHP_EOL . "</table>" . PHP_EOL;
//
if ($accordion) {
$str_html .= "</div>" . PHP_EOL;
}
}
return $str_html;
}
/**
* Create an HTML rendition of the 835 check payment transaction.
*
*
* @param array
* @param object
* @param object
* @param array
* @param string
*
* @return string HTML table
*/
function edih_835_payment_html($segments, $codes27x, $codes835, $delimiters, $fname = '')
{
//
$str_html = '';
$pid = $chk = '';
if (is_array($segments) && count($segments)) {
$trans_ar = $segments;
} else {
csv_edihist_log("edih_835_payment_html: invalid segments argument");
$str_html .= "<p>invalid segments argument</p>" . PHP_EOL;
return $str_html;
}
if (is_array($delimiters) && count($delimiters)) {
$de = $delimiters['e'];
$ds = $delimiters['s'];
$dr = $delimiters['r'];
} else {
csv_edihist_log("edih_835_payment_html: invalid delimiters argument");
$str_html .= "<p>invalid delimiters argument</p>" . PHP_EOL;
return $str_html;
}
//
$fn = $fname ? trim($fname) : "";
//
// get the code objects right
$cd835 = $cd27x = '';
if ('edih_835_codes' == get_class($codes835)) {
$cd835 = $codes835;
} elseif ('edih_835_codes' == get_class($codes27x)) {
$cd835 = $codes27x;
}
if ('edih_271_codes' == get_class($codes27x)) {
$cd27x = $codes27x;
} elseif ('edih_271_codes' == get_class($codes835)) {
$cd27x = $codes835;
}
if (!$cd835 || !$cd27x) {
csv_edihist_log('edih_835_payment_html: invalid code class argument');
$str_html .= "<p>invalid code class argument</p>" . PHP_EOL;
return $str_html;
}
//
// collect all strings into this variable
$str_html = "";
//
$hdr_html = "<thead>" . PHP_EOL;
$hdr_html .= "<tr><th>Reference</th><th colspan=2>Information</th><th colspan=2>{$fn}</th></tr>" . PHP_EOL;
$hdr_html .= "</thead>" . PHP_EOL . "<tbody>" . PHP_EOL;
$pmt_html = "";
$src_html = "";
$rcv_html = "";
$lx_html = "";
$clp_html = "";
$trl_html = "";
//
$acctng = array('pmt' => 0, 'fee' => 0, 'clmpmt' => 0, 'clmadj' => 0, 'ptrsp' => 0, 'svcptrsp' => 0, 'svcfee' => 0, 'svcadj' => 0, 'plbadj' => 0);
//
foreach ($trans_ar as $trans) {
$clpsegs = array();
$lx_ar = array();
$clp_ct = 0;
$lx_ct = 0;
$loop = '';
$lxkey = '';
$capstr = "Remittance ";
$tblid = "";
//
foreach ($trans as $seg) {
//
if (strncmp('ST' . $de, $seg, 3) === 0) {
$loopid = 'header';
continue;
}
//
if (strncmp('BPR' . $de, $seg, 4) === 0) {
$loopid = 'header';
$cls = 'pmt';
//
$acctng = array('pmt' => 0, 'fee' => 0, 'clmpmt' => 0, 'clmadj' => 0, 'ptrsp' => 0, 'svcptrsp' => 0, 'svcfee' => 0, 'svcpmt' => 0, 'svcadj' => 0, 'plbadj' => 0);
//
$sar = explode($de, $seg);
$bpr01 = isset($sar[1]) && $sar[1] ? $cd835->get_835_code('BPR01', $sar[1]) : '';
// handling code
$bpr02 = isset($sar[2]) && $sar[2] ? edih_format_money($sar[2]) : '';
// full payment amount
$bpr03 = isset($sar[3]) && $sar[3] == 'D' ? 'Debit' : 'Credit';
// credit or debit flag
$bpr04 = isset($sar[4]) && $sar[4] ? $sar[4] : '';
// payment method ACH|CHK|NON
$bpr05 = isset($sar[5]) && $sar[5] ? $sar[5] : '';
// payment format code CCP|CTX
$bpr06 = isset($sar[6]) && $sar[6] ? $sar[6] : '';
// DFI ID qualifier
$bpr07 = isset($sar[7]) && $sar[7] ? $sar[7] : '';
// bank ID
$bpr08 = isset($sar[8]) && $sar[8] ? $sar[8] : '';
// account no. qualifier DA
$bpr09 = isset($sar[9]) && $sar[9] ? $sar[9] : '';
// sender account number
$bpr10 = isset($sar[10]) && $sar[10] ? $sar[10] : '';
// originating company ID
$bpr11 = isset($sar[11]) && $sar[11] ? $sar[11] : '';
// originating company supplemental ID
$bpr12 = isset($sar[12]) && $sar[12] ? $sar[12] : '';
// deposit acount ID
$bpr13 = isset($sar[13]) && $sar[13] ? $sar[13] : '';
// deposit bank ID
$bpr14 = isset($sar[14]) && $sar[14] ? $sar[14] : '';
// account type DA deposit SG savings
$bpr15 = isset($sar[15]) && $sar[15] ? $sar[15] : '';
// account number
$bpr16 = isset($sar[16]) && $sar[16] ? edih_format_date($sar[16]) : '';
// check or payment date
//
if ($bpr04 == 'NON') {
$pmt_html .= "<tr class='{$cls}'><td>{$bpr16}</td><td>{$bpr03} {$bpr04}</td><td colspan=2>Non Payment</td></tr>" . PHP_EOL;
} else {
$pmt_html .= "<tr class='{$cls}'><td>{$bpr16}</td><td>{$bpr03} {$bpr04}</td><td colspan=2>{$bpr02} to {$bpr13} {$bpr12} {$bpr14}</td></tr>" . PHP_EOL;
}
if (strpos('|ACH|BOP|FWT', $bpr04)) {
$pmt_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$bpr05} from: {$bpr07} {$bpr09} {$bpr10}</td></tr>" . PHP_EOL;
}
$pmt_html .= $bpr11 ? "<tr class='{$cls}'><td>></td><td colspan=3><em>Pmt No.</em> {$bpr11} {$bpr01}</td></tr>" . PHP_EOL : "";
$acctng['pmt'] = isset($sar[2]) && $sar[2] ? (double) $sar[2] : "";
//
continue;
}
//
if (strncmp('TRN' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$trn01 = isset($sar[1]) && $sar[1] ? $sar[1] : '';
// trace type code
$trn02 = isset($sar[2]) && $sar[2] ? $sar[2] : '';
// trace number (= BPR11)
$trn03 = isset($sar[3]) && $sar[3] ? $sar[3] : '';
// originator ID
$trn04 = isset($sar[4]) && $sar[4] ? $sar[4] : '';
// originator supplemental ID
if ($trn03[0] == '1') {
$trn03 = substr($trn03, 1);
}
// originator ID is '1' prepended to EIN or TIN
// the html ID for the table
$tblid = $trn02 ? $trn02 : "";
$capstr .= $trn02 ? "Check No: " . $trn02 : "Payment Listing";
//
$pmt_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>Trace</em> {$trn02} <em>by</em> {$trn03} {$trn04}</td></tr>" . PHP_EOL;
//
continue;
}
//
if (strncmp('CUR' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$cur01 = isset($sar[1]) ? $sar[1] : '';
// entity ID code
$cur02 = isset($sar[2]) ? $sar[2] : '';
// currency code
//
$pmt_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>Trace</em> {$cur02} by {$cur03} {$cur04}</td></tr>" . PHP_EOL;
//
continue;
}
//
if (strncmp('REF' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
//
$ref01 = isset($sar[1]) ? $cd27x->get_271_code('REF', $sar[1]) : '';
// entity ID code
$ref02 = isset($sar[2]) ? $sar[2] : '';
// entity ID
//
if ($loopid == 'header') {
// should not be present for payee receiver
$pmt_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$ref01}</em> {$ref02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '1000A') {
// source
$src_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$ref01}</em> {$ref02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '1000B') {
// receiver
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$ref01}</em> {$ref02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100') {
//
$clpsegs[] = $seg;
} elseif ($loopid == '2110') {
//
$clpsegs[] = $seg;
}
//
continue;
}
if (strncmp('DTM' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
// DTM in 835 use DTP codes from 271 codes
$dtm01 = isset($sar[1]) ? $cd27x->get_271_code('DTP', $sar[1]) : '';
// date qualifier
$dtm02 = isset($sar[2]) ? edih_format_date($sar[2]) : '';
// production date
$dtm05 = isset($sar[5]) ? $sar[5] : '';
$dtm06 = isset($sar[6]) ? edih_format_date($sar[2]) : '';
//
//if ( $elem02 == 'D8' && $elem03) {
//$dtmar = edih_format_date($elem03);
//} elseif ( $elem02 == 'RD8' && $elem03) {
//$dtmar = edih_format_date( substr($elem03, 0, 8) );
//$dtmar .= ' - '.edih_format_date( substr($elem03, -8) );
//}
//}
//
if ($loopid == 'header') {
// should not be present for payee or receiver
$pmt_html .= "<tr class='{$cls}'><td>></td><td colspan=3><em>{$dtm01}</em> {$dtm02}</td></tr>" . PHP_EOL;
} elseif ($loopid == '2100') {
$clpsegs[] = $seg;
} elseif ($loopid == '2110') {
$clpsegs[] = $seg;
}
//
continue;
}
//
if (strncmp('N1' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
//
$n101 = isset($sar[1]) ? $cd27x->get_271_code('NM101', $sar[1]) : '';
// entity ID code
$n102 = isset($sar[2]) ? $sar[2] : '';
// name
$n103 = isset($sar[3]) ? $cd27x->get_271_code('NM108', $sar[3]) : '';
// entity ID type code
$n104 = isset($sar[4]) ? $sar[4] : '';
//
if ($loopid == 'header') {
$loopid = '1000A';
$cls = 'src';
$src_html .= "<tr class='{$cls}'><td><em>{$n101}</em></td><td colspan=3>{$n102} <em>{$n103}</em> {$n104}</td></tr>" . PHP_EOL;
} elseif ($loopid == '1000A') {
$loopid = '1000B';
$cls = 'rcv';
$rcv_html .= "<tr class='{$cls}'><td><em>{$n101}</em></td><td colspan=3>{$n102} <em>{$n103}</em> {$n104}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('N3' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
//
$n301 = isset($sar[1]) ? $sar[1] : '';
// address
$n302 = isset($sar[2]) ? $sar[2] : '';
// address line 2
//
if ($loopid == '1000A') {
$src_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$n301} {$n302}</td></tr>" . PHP_EOL;
} elseif ($loopid == '1000B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$n301} {$n302}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('N4' . $de, $seg, 3) === 0) {
$sar = explode($de, $seg);
//
$n401 = isset($sar[1]) ? $sar[1] : '';
// city
$n402 = isset($sar[2]) ? $sar[2] : '';
// state
$n403 = isset($sar[3]) ? $sar[3] : '';
// Postal
$n404 = isset($sar[4]) ? $sar[4] : '';
// Country
$n407 = isset($sar[7]) ? $sar[7] : '';
// Country subdivision
//
if ($loopid == '1000A') {
$src_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$n401} {$n402} {$n403}</td></tr>" . PHP_EOL;
$src_html .= $n404 || $n407 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$n404} {$n405}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '1000B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$n401} {$n402} {$n403}</td></tr>" . PHP_EOL;
$rcv_html .= $n404 || $n407 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$n404} {$n405}</td></tr>" . PHP_EOL : "";
}
//
continue;
}
//
if (strncmp('PER' . $de, $seg, 4) === 0) {
if ($loopid == '2100' || $loopid == '2100') {
// loop 2100 only
$clpsegs[] = $seg;
continue;
}
$sar = explode($de, $seg);
$per01_ar = array('CX' => 'Claims Dept', 'BL' => 'Technical Dept', 'IC' => 'Website');
$per01 = $per02 = $per03 = $per04 = $per05 = $per06 = $per07 = $per08 = '';
foreach ($sar as $k => $v) {
switch ((int) $k) {
case 0:
break;
case 1:
$per01 = isset($per01_ar[$v]) ? $per01_ar[$v] : $v;
break;
case 2:
$per02 = $v;
break;
case 3:
$per03 = $v;
break;
case 4:
$per04 = $per03 == 'TE' ? edih_format_telephone($v) : $v;
break;
case 5:
$per05 = $v;
break;
case 6:
$per06 = $per03 == 'TE' ? edih_format_telephone($v) : $v;
break;
case 7:
$per07 = $v;
break;
case 8:
$per08 = $per03 == 'TE' ? edih_format_telephone($v) : $v;
}
}
//
if ($loopid == '1000A') {
$src_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$per01} {$per02} {$per03} {$per04} </td></tr>" . PHP_EOL;
$src_html .= $per05 || $per07 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$per05} {$per06} {$per07} {$per08}</td></tr>" . PHP_EOL : "";
} elseif ($loopid == '1000B') {
$rcv_html .= "<tr class='{$cls}'><td>></td><td colspan=3>{$per01} {$per02} {$per03} {$per04} </td></tr>" . PHP_EOL;
$rcv_html .= $per05 || $per07 ? "<tr class='{$cls}'><td>></td><td colspan=3>{$per05} {$per06} {$per07} {$per08}</td></tr>" . PHP_EOL : "";
}
//
continue;
}
//
if (strncmp('RDM' . $de, $seg, 4) === 0) {
// remittance delivery method
// loop 1000B -- add to pmt information
$sar = explode($de, $seg);
//
$rdm01 = isset($sar[1]) ? $sar[1] : '';
if ($sar[1] == 'BM') {
$rdm01 = 'By mail';
} elseif ($sar[1] == 'EM') {
$rdm01 = 'By e-mail';
} elseif ($sar[1] == 'FT') {
$rdm01 = 'By file transfer';
} elseif ($sar[1] == 'OL') {
$rdm01 = 'By online';
}
$rdm02 = isset($sar[2]) ? $sar[2] : '';
// name
$rdm03 = isset($sar[3]) ? $sar[3] : '';
// number
//
$pmt_html .= "<tr class='{$cls}'><td>{$rdm01}</td><td colspan=3>{$rdm02} {$rdm03}</td></tr>" . PHP_EOL;
//
continue;
}
//
if (strncmp('LX' . $de, $seg, 3) === 0) {
// LX can end loop 1000B or a claim grouping
if ($loopid == '1000B') {
// finish off pmt, src, and rcv
$rcv_html .= "</tbody>" . PHP_EOL . "</table>" . PHP_EOL;
} elseif ($loopid == '2110') {
if ($lxkey && array_key_exists($lxkey, $lx_ar)) {
// LX claim grouping -- cannot predict detail
// LX can follow loop 2110
if (count($clpsegs)) {
$clp_html .= edih_835_transaction_html($clpsegs, $codes27x, $codes835, $delimiters);
$clpsegs = array();
}
$nlx_html = $lx_html ? "<table name='lx_{$lxkey}' class='h835c' columns=4>" . PHP_EOL . "<tbody>" . PHP_EOL . $lx_html . PHP_EOL : "";
$lx_ar[$lxkey]['lx'] = $nlx_html;
$lx_ar[$lxkey]['clp'] = $clp_html;
$lx_html = "";
$clp_html = "";
$clpsegs = array();
}
}
$sar = explode($de, $seg);
$lxkey = isset($sar[1]) && $sar[1] ? $sar[1] : '';
// identify a grouping for claim info
$lx_ar[$lxkey] = array();
//
$loopid = '2000';
$cls = 'lx';
//$lx_ct = count($lx_ar);
$lx_html .= $lxkey ? "<tr class='{$cls}'><td colspan=4><em>Claim Group</em> {$lxkey}</td></tr>" . PHP_EOL : "";
continue;
}
//
if (strncmp('TS3' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
// this looks like a medicare part A or hospital remittance segment
// segment TS2 gives DRG totals -- not read in this sequence. If you need it, code it
$loopid = '2000';
$ts301 = isset($sar[1]) && $sar[1] ? $sar[1] : '';
// Provider ID
$ts302 = isset($sar[2]) && $sar[2] ? $cd27x->get_271_code('POS', $sar[2]) : '';
// Facility Code (place of service)
$ts303 = isset($sar[3]) && $sar[3] ? edih_format_date($sar[3]) : '';
// date - last day of provider fiscal year
$ts304 = isset($sar[4]) && $sar[4] ? $sar[4] : '';
// quantity
$ts305 = isset($sar[5]) && $sar[5] ? edih_format_money($sar[5]) : '';
// monetary amount
//
$lx_html .= "<tr class='{$cls}'><td><em>Prv</em> {$ts301}</td><td colspan=3>{$ts302} <em>Count</em> {$ts304} <em>Amount</em> {$ts305}</td></tr>" . PHP_EOL;
//
// Medicare Part A
$tr1 = "<tr class='{$cls}'><td>></td><td colspan=3>";
$tr2 = "</td></tr>" . PHP_EOL;
//
$lx_html .= isset($sar[13]) && $sar[13] ? $tr1 . "Total MSP Payer Amt: " . edih_format_money($sar[13]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[15]) && $sar[15] ? $tr1 . "Total Non-Lab Chrg Amt: " . edih_format_money($sar[15]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[17]) && $sar[17] ? $tr1 . "Total HCPCS Rpt Chrg Amt: " . edih_format_money($sar[17]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[18]) && $sar[18] ? $tr1 . "Total HCPCS Payable Amt: " . edih_format_money($sar[18]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[20]) && $sar[20] ? $tr1 . "Total Prof Cmpnt Amt: " . edih_format_money($sar[20]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[21]) && $sar[21] ? $tr1 . "Total MSP Pt Liab Met Amt: " . edih_format_money($sar[21]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[22]) && $sar[22] ? $tr1 . "Total MSP Pt Reimb Amt: " . edih_format_money($sar[22]) . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[23]) && $sar[23] ? $tr1 . "Total PIP Claim Count: " . $sar[23] . $tr2 . PHP_EOL : "";
$lx_html .= isset($sar[24]) && $sar[24] ? $tr1 . "Total PIP Claim Count: " . edih_format_money($sar[24]) . $tr2 . PHP_EOL : "";
//
continue;
}
//
if (strncmp('TS2' . $de, $seg, 4) === 0) {
csv_edihist_log("edih_835_transaction_html: segment TS2 present in {$fn}");
// Medicare Part A
$tr1 = "<tr class='{$cls}'><td>></td><td colspan=3>";
$tr2 = "</td></tr>" . PHP_EOL;
//
$lx_html .= isset($sar[1]) && $sar[1] ? $tr1 . "Total DRG Amt: " . edih_format_money($sar[1]) . $tr2 : "";
$lx_html .= isset($sar[2]) && $sar[2] ? $tr1 . "Total Fed Specific Amt: " . edih_format_money($sar[2]) . $tr2 : "";
$lx_html .= isset($sar[3]) && $sar[3] ? $tr1 . "Total Hosp Specific Amt: " . edih_format_money($sar[3]) . $tr2 : "";
$lx_html .= isset($sar[4]) && $sar[4] ? $tr1 . "Total DSP Share Amt: " . edih_format_money($sar[4]) . $tr2 : "";
$lx_html .= isset($sar[5]) && $sar[5] ? $tr1 . "Total Capital Amt: " . edih_format_money($sar[5]) . $tr2 : "";
$lx_html .= isset($sar[6]) && $sar[6] ? $tr1 . "Total Ind Med Edu Amt: " . edih_format_money($sar[6]) . $tr2 : "";
$lx_html .= isset($sar[7]) && $sar[7] ? $tr1 . "Total Outlier Day Amt: " . edih_format_money($sar[7]) . $tr2 : "";
$lx_html .= isset($sar[8]) && $sar[8] ? $tr1 . "Total Day Outlier Day Amt: " . edih_format_money($sar[8]) . $tr2 : "";
$lx_html .= isset($sar[9]) && $sar[9] ? $tr1 . "Total Cost Outlier Day Amt: " . edih_format_money($sar[9]) . $tr2 : "";
$lx_html .= isset($sar[10]) && $sar[10] ? $tr1 . "Avg DRG Length of Stay: " . $sar[10] . $tr2 : "";
$lx_html .= isset($sar[11]) && $sar[11] ? $tr1 . "Total Discharge Count: " . $sar[11] . $tr2 : "";
$lx_html .= isset($sar[12]) && $sar[12] ? $tr1 . "Total Cost Rpt Day Count: " . $sar[12] . $tr2 : "";
$lx_html .= isset($sar[13]) && $sar[13] ? $tr1 . "Total Covered Day Count: " . $sar[13] . $tr2 : "";
$lx_html .= isset($sar[14]) && $sar[14] ? $tr1 . "Total Non Covered Day Count: " . $sar[14] . $tr2 : "";
$lx_html .= isset($sar[15]) && $sar[15] ? $tr1 . "Total MSP Pass-Thru Amt: " . edih_format_money($sar[15]) . $tr2 : "";
$lx_html .= isset($sar[16]) && $sar[16] ? $tr1 . "Avg DRG Weight: " . $sar[16] . $tr2 : "";
$lx_html .= isset($sar[17]) && $sar[17] ? $tr1 . "Total PPS Capital FSP DRG Amt: " . edih_format_money($sar[17]) . $tr2 : "";
$lx_html .= isset($sar[18]) && $sar[18] ? $tr1 . "Total PPS Capital FSP HSP Amt: " . edih_format_money($sar[18]) . $tr2 : "";
$lx_html .= isset($sar[19]) && $sar[19] ? $tr1 . "Total PPS DSH DRG Amt: " . edih_format_money($sar[19]) . $tr2 : "";
//
continue;
}
if (strncmp('PLB' . $de, $seg, 4) === 0) {
// can signal end of claim transaction
$loopid = 'summary';
$cls = 'pmt';
//if (count($clpsegs)) {
//$clp_html .= edih_835_transaction_html($clpsegs, $codes27x, $codes835, $delimiters);
//$clpsegs = array();
//}
//
$sar = explode($de, $seg);
// provider ID and fiscal year end date
$plb01 = isset($sar[1]) && $sar[1] ? $sar[1] : "";
$plb02 = isset($sar[2]) && $sar[2] ? edih_format_date($sar[2]) : "";
//
$pmt_html .= "<tr class='{$cls}'><td><em>Provider</em></td><td colspan=3>{$plb01} {$plb02}</td></tr>" . PHP_EOL;
//
$plbar = array_slice($sar, 2);
$plbar = array_chunk($plbar, 2);
// reason code and amount
foreach ($plbar as $plb) {
foreach ($plb as $k => $p) {
// PLB 3, 5, 7, 9, 11, 13
// composite element 'code:reference'
if ($k == 0) {
if ($p && strpos($p, $ds)) {
$plb_rc = substr($p, 0, strpos($p, $ds));
// code
$plb_tr = substr($p, strpos($p, $ds) + 1);
// reference (case #)?
} else {
$plb_rc = $p ? $p : "";
$plb_tr = "";
}
$plb_rt = $plb_rc ? $cd835->get_835_code('PLB', $plb_rc) : "";
} else {
// PLB 4, 6, 8, 10, 12, 14
// monetary amount
$plb_amt = $p ? edih_format_money($p) : "";
$acctng['plbadj'] += $p ? (double) $p : 0;
}
}
$pmt_html .= "<tr class='{$cls}'><td>{$plb_tr}</td><td colspan=3>{$plb_rc} {$plb_rt} {$plb_amt}</td></tr>" . PHP_EOL;
}
//
continue;
}
//
if (strncmp('SE' . $de, $seg, 3) === 0) {
// end of payment transaction, so create the html page
$loopid = 'trailer';
$cls = 'pmt';
// include our accounting totals
if (is_array($acctng) && count($acctng)) {
array_walk($acctng, 'edih_round_cb');
$bal = $acctng['fee'] == $acctng['pmt'] + $acctng['clmadj'] + $acctng['svcadj'] + $acctng['svcptrsp'] + $acctng['plbadj'] ? "Balanced" : "Not Balanced";
$acct_str = "{$bal}: <em>Fee</em> {$acctng['fee']} <em>Pmt</em> {$acctng['pmt']} ";
$acct_str .= "<em>ClpAdj</em> {$acctng['clmadj']} <em>SvcAdj</em> {$acctng['svcadj']} ";
$acct_str .= "<em>PtRsp</em> {$acctng['ptrsp']} (<em>svcPtRsp</em> {$acctng['svcptrsp']}) <em>PlbAdj</em> {$acctng['plbadj']} ";
//
$pmt_html .= "<tr class='{$cls}'><td colspan=4>{$acct_str}</td></tr>" . PHP_EOL;
}
//
// create the html page
$str_html .= "<table id={$tblid} class='h835' columns=4><caption>{$capstr}</caption>" . PHP_EOL;
$str_html .= $hdr_html;
if ($pmt_html) {
$str_html .= $pmt_html;
$pmt_html = "";
}
if ($src_html) {
$str_html .= $src_html;
$src_html = "";
}
if ($rcv_html) {
$str_html .= $rcv_html;
$rcv_html = "";
}
//
if (count($lx_ar)) {
// claim segments are in lx array
// make sure we have current collection
if ($lxkey && array_key_exists($lxkey, $lx_ar)) {
if (count($clpsegs)) {
$clp_html .= edih_835_transaction_html($clpsegs, $codes27x, $codes835, $delimiters);
$clpsegs = array();
}
// note: table ending in CLP if stanza
$nlx_html = "<table name='lx_{$lxkey}' class='h835c' columns=4>" . PHP_EOL . "<tbody>" . PHP_EOL . $lx_html . PHP_EOL;
$lx_ar[$lxkey]['lx'] = $nlx_html;
$lx_ar[$lxkey]['clp'] = $clp_html;
$lx_html = "";
$clp_html = "";
$clpsegs = array();
}
// append segments to html
foreach ($lx_ar as $key => $val) {
$str_html .= $val['lx'];
$str_html .= $val['clp'];
}
} elseif ($lx_html) {
$str_html .= $lx_html;
$lx_html = "";
}
//
if (count($clpsegs)) {
// would be captured in LX and lx array
$clp_html .= edih_835_transaction_html($clpsegs, $codes27x, $codes835, $delimiters);
$clpsegs = array();
}
if ($clp_html) {
$str_html .= $clp_html;
$clp_html = "";
}
if ($trl_html) {
$str_html .= $trl_html;
$trl_html = "";
}
//$str_html .= "</tbody>".PHP_EOL."</table>".PHP_EOL;
//
continue;
}
if (strncmp('CLP' . $de, $seg, 4) === 0) {
if ($loopid == '1000B') {
// end of 1000B (receiver) loop
$rcv_html .= $clp_ct ? "" : "</tbody>" . PHP_EOL . "</table>" . PHP_EOL;
} elseif ($loopid == '2000') {
// end of LX header (LX TS3 TS2 claim grouping)
$lx_html .= $clp_ct ? "" : "</tbody>" . PHP_EOL . "</table>" . PHP_EOL;
}
$loopid = '2100';
//array('pmt'=>0, 'clmpmt'=>0, 'clmadj'=0, 'prvadj'=>0, 'ptrsp'=>0,'lx'=>array());
$sar = explode($de, $seg);
$acctng['fee'] += isset($sar[3]) && $sar[3] ? (double) $sar[3] : 0;
$acctng['clmpmt'] += isset($sar[4]) && $sar[4] ? (double) $sar[4] : 0;
$acctng['ptrsp'] += isset($sar[5]) && $sar[5] ? (double) $sar[5] : 0;
//
if (count($clpsegs)) {
$clp_html .= edih_835_transaction_html($clpsegs, $codes27x, $codes835, $delimiters);
}
$clpsegs = array();
$clpsegs[] = $seg;
$clp_ct++;
continue;
}
if (strncmp('SVC' . $de, $seg, 4) === 0) {
$loopid = '2110';
$sar = explode($de, $seg);
$pmtm = $pmts = 1;
foreach ($sar as $k => $v) {
if ($k == 2) {
$svcfee = $v ? (double) $v : 0;
} elseif ($k == 3) {
$svcpmt = $v ? (double) $v : 0;
} elseif ($k == 5) {
$pmtm = $v ? (int) $v : 1;
} elseif ($k == 7) {
$pmts = $v ? (int) $v : 1;
}
}
$acctng['svcfee'] += $svcfee * $pmts;
$acctng['svcpmt'] += $svcpmt * $pmtm;
//
$clpsegs[] = $seg;
continue;
}
if (strncmp('CAS' . $de, $seg, 4) === 0) {
$sar = explode($de, $seg);
// category
$ctg = isset($sar[1]) && $sar[1] ? $sar[1] : 'CO';
// slice sar array to get triplet elements
// chunk into triplets
$sar1 = array_slice($sar, 2);
$sar1 = array_chunk($sar1, 3);
//
foreach ($sar1 as $cas) {
$cav = 0;
$cq = '';
foreach ($cas as $k => $v) {
if ($k == 1) {
// monetary amount elem 3, 6, 9, 12, 15, 18
$cav = $v ? $v : 0;
} elseif ($k == 2) {
// quantity elem 4, 7, 10, 13, 16, 19
$cq = $v ? $v : "";
if ($cq && strcmp($cq, '1') > 0) {
$cav = $cav * $cq;
}
}
}
if ($ctg == 'PR') {
$acctng['svcptrsp'] += $cav ? (double) $cav : 0;
} else {
$acctky = $loopid == '2100' ? 'clmadj' : 'svcadj';
$acctng[$acctky] += $cav ? (double) $cav : 0;
}
}
$clpsegs[] = $seg;
continue;
}
// uncaught segments should be routed by this
if ($loopid == '2100' || $loopid == '2110') {
$clpsegs[] = $seg;
continue;
}
}
// end foreach(trans as seg)
}
// end foreach(trans_ar as trans)
//
return $str_html;
}
