interface/patient_file/front_payment.php

   1 <?php
   2
   3 /**
   4  * Front payment gui.
   5  *
   6  * @package   OpenEMR
   7  * @link      http://www.open-emr.org
   8  * @author    Rod Roark <rod@sunsetsystems.com>
   9  * @author    Brady Miller <brady.g.miller@gmail.com>
  10  * @copyright Copyright (c) 2006-2020 Rod Roark <rod@sunsetsystems.com>
  11  * @copyright Copyright (c) 2017-2018 Brady Miller <brady.g.miller@gmail.com>
  12  * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  13  */
  14
  15 require_once("../globals.php");
  16 require_once("$srcdir/patient.inc.php");
  17 require_once("$srcdir/payment.inc.php");
  18 require_once("$srcdir/forms.inc.php");
  19 require_once("../../custom/code_types.inc.php");
  20 require_once("$srcdir/options.inc.php");
  21 require_once("$srcdir/encounter_events.inc.php");
  22
  23 use OpenEMR\Billing\BillingUtilities;
  24 use OpenEMR\Common\Acl\AclMain;
  25 use OpenEMR\Common\Csrf\CsrfUtils;
  26 use OpenEMR\Common\Twig\TwigContainer;
  27 use OpenEMR\Core\Header;
  28 use OpenEMR\OeUI\OemrUI;
  29 use OpenEMR\PaymentProcessing\Sphere\SpherePayment;
  30 use OpenEMR\Services\FacilityService;
  31
  32 if (!empty($_REQUEST['receipt']) && empty($_POST['form_save'])) {
  33     if (!AclMain::aclCheckCore('acct', 'bill') && !AclMain::aclCheckCore('acct', 'rep_a') && !AclMain::aclCheckCore('patients', 'rx')) {
  34         echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => xl("Receipt for Payment")]);
  35         exit;
  36     }
  37 } else {
  38     if (!AclMain::aclCheckCore('acct', 'bill', '', 'write')) {
  39         if (!empty($_POST['form_save'])) {
  40             $pageTitle = xl("Receipt for Payment");
  41         } else {
  42             $pageTitle = xl("Record Payment");
  43         }
  44         echo (new TwigContainer(null, $GLOBALS['kernel']))->getTwig()->render('core/unauthorized.html.twig', ['pageTitle' => $pageTitle]);
  45         exit;
  46     }
  47 }
  48
  49 $pid = (!empty($_REQUEST['hidden_patient_code']) && ($_REQUEST['hidden_patient_code'] > 0)) ? $_REQUEST['hidden_patient_code'] : $pid;
  50
  51 $facilityService = new FacilityService();
  52
  53 ?>
  54 <!DOCTYPE html>
  55 <html>
  56 <head>
  57 <?php Header::setupHeader(['opener']);?>
  58     <?php if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
  59         <script src="https://js.stripe.com/v3/"></script>
  60     <?php } ?>
  61     <?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') {
  62         // Must be loaded from their server
  63         $script = "https://jstest.authorize.net/v1/Accept.js"; // test script
  64         if ($GLOBALS['gateway_mode_production']) {
  65             $script = "https://js.authorize.net/v1/Accept.js"; // Production script
  66         } ?>
  67         <script src=<?php echo $script; ?> charset="utf-8"></script>
  68     <?php } ?>
  69 <?php
  70 // Format dollars for display.
  71
  72 function bucks($amount)
  73 {
  74     if ($amount) {
  75         $amount = oeFormatMoney($amount);
  76         return $amount;
  77     }
  78     return '';
  79 }
  80
  81 function rawbucks($amount)
  82 {
  83     if ($amount) {
  84         $amount = sprintf("%.2f", $amount);
  85         return $amount;
  86     }
  87     return '';
  88 }
  89
  90 // Display a row of data for an encounter.
  91 //
  92 $var_index = 0;
  93 function echoLine($iname, $date, $charges, $ptpaid, $inspaid, $duept, $encounter = 0, $copay = 0, $patcopay = 0)
  94 {
  95     global $var_index;
  96     $var_index++;
  97     $balance = bucks($charges - $ptpaid - $inspaid);
  98     $balance = (round($duept, 2) != 0) ? 0 : $balance;//if balance is due from patient, then insurance balance is displayed as zero
  99     $encounter = $encounter ? $encounter : '';
 100     echo " <tr id='tr_" . attr($var_index) . "' >\n";
 101     echo "  <td>" . text(oeFormatShortDate($date)) . "</td>\n";
 102     echo "  <td class='text-center' id='" . attr($date) . "'>" . text($encounter) . "</td>\n";
 103     echo "  <td class='text-center' id='td_charges_$var_index' >" . text(bucks($charges)) . "</td>\n";
 104     echo "  <td class='text-center' id='td_inspaid_$var_index' >" . text(bucks($inspaid * -1)) . "</td>\n";
 105     echo "  <td class='text-center' id='td_ptpaid_$var_index' >" . text(bucks($ptpaid * -1)) . "</td>\n";
 106     echo "  <td class='text-center' id='td_patient_copay_$var_index' >" . text(bucks($patcopay)) . "</td>\n";
 107     echo "  <td class='text-center' id='td_copay_$var_index' >" . text(bucks($copay)) . "</td>\n";
 108     echo "  <td class='text-center' id='balance_$var_index'>" . text(bucks($balance)) . "</td>\n";
 109     echo "  <td class='text-center' id='duept_$var_index'>" . text(bucks(round($duept, 2) * 1)) . "</td>\n";
 110     echo "  <td class='text-right'><input type='text' class='form-control' name='" . attr($iname) . "'  id='paying_" . attr($var_index) . "' " .
 111         " value='' onchange='coloring();calctotal()'  autocomplete='off' " .
 112         "onkeyup='calctotal()'/></td>\n";
 113     echo " </tr>\n";
 114 }
 115
 116 // We use this to put dashes, colons, etc. back into a timestamp.
 117 //
 118 function decorateString($fmt, $str)
 119 {
 120     $res = '';
 121     while ($fmt) {
 122         $fc = substr($fmt, 0, 1);
 123         $fmt = substr($fmt, 1);
 124         if ($fc == '.') {
 125             $res .= substr($str, 0, 1);
 126             $str = substr($str, 1);
 127         } else {
 128             $res .= $fc;
 129         }
 130     }
 131
 132     return $res;
 133 }
 134
 135 // Compute taxes from a tax rate string and a possibly taxable amount.
 136 //
 137 function calcTaxes($row, $amount)
 138 {
 139     $total = 0;
 140     if (empty($row['taxrates'])) {
 141         return $total;
 142     }
 143
 144     $arates = explode(':', $row['taxrates']);
 145     if (empty($arates)) {
 146         return $total;
 147     }
 148
 149     foreach ($arates as $value) {
 150         if (empty($value)) {
 151             continue;
 152         }
 153
 154         $trow = sqlQuery("SELECT option_value FROM list_options WHERE " .
 155                 "list_id = 'taxrate' AND option_id = ? AND activity = 1 LIMIT 1", array($value));
 156         if (empty($trow['option_value'])) {
 157             echo "<!-- Missing tax rate '" . text($value) . "'! -->\n";
 158             continue;
 159         }
 160
 161         $tax = sprintf("%01.2f", $amount * $trow['option_value']);
 162         // echo "<!-- Rate = '$value', amount = '$amount', tax = '$tax' -->\n";
 163         $total += $tax;
 164     }
 165
 166     return $total;
 167 }
 168
 169 $now = time();
 170 $today = date('Y-m-d', $now);
 171 $timestamp = date('Y-m-d H:i:s', $now);
 172
 173 $patdata = sqlQuery("SELECT " .
 174     "p.fname, p.mname, p.lname, p.pubpid,p.pid, i.copay " .
 175     "FROM patient_data AS p " .
 176     "LEFT OUTER JOIN insurance_data AS i ON " .
 177     "i.pid = p.pid AND i.type = 'primary' " .
 178     "WHERE p.pid = ? ORDER BY i.date DESC LIMIT 1", array($pid));
 179
 180 $alertmsg = ''; // anything here pops up in an alert box
 181
 182 // If the Save button was clicked...
 183 if (!empty($_POST['form_save'])) {
 184     if (!CsrfUtils::verifyCsrfToken($_POST["csrf_token_form"])) {
 185         CsrfUtils::csrfNotVerified();
 186     }
 187
 188     $form_pid = $_POST['form_pid'];
 189     $form_method = trim($_POST['form_method']);
 190     $form_source = trim($_POST['form_source']);
 191     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 192     $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname'];
 193
 194     if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
 195             $payment_id = sqlInsert(
 196                 "insert into ar_session set " .
 197                 "payer_id = ?" .
 198                 ", patient_id = ?" .
 199                 ", user_id = ?" .
 200                 ", closed = ?" .
 201                 ", reference = ?" .
 202                 ", check_date =  now() , deposit_date = now() " .
 203                 ",  pay_total = ?" .
 204                 ", payment_type = 'patient'" .
 205                 ", description = ?" .
 206                 ", adjustment_code = 'pre_payment'" .
 207                 ", post_to_date = now() " .
 208                 ", payment_method = ?",
 209                 array(0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $_REQUEST['form_prepayment'], $NameNew, $form_method)
 210             );
 211
 212          frontPayment($form_pid, 0, $form_method, $form_source, $_REQUEST['form_prepayment'], 0, $timestamp);//insertion to 'payments' table.
 213     }
 214
 215     if ($_POST['form_upay'] && $_REQUEST['radio_type_of_payment'] != 'pre_payment') {
 216         foreach ($_POST['form_upay'] as $enc => $payment) {
 217             $payment = floatval($payment);
 218             if ($amount = $payment) {
 219                  $zero_enc = $enc;
 220                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance') {
 221                     if (!$enc) {
 222                         $enc = calendar_arrived($form_pid);
 223                     }
 224                 } else {
 225                     if (!$enc) {
 226                            $enc = calendar_arrived($form_pid);
 227                     }
 228                 }
 229
 230                 //----------------------------------------------------------------------------------------------------
 231                   //Fetching the existing code and modifier
 232                   $ResultSearchNew = sqlStatement(
 233                       "SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key " .
 234                       "WHERE code_types.ct_fee=1 AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier",
 235                       array($form_pid, $enc)
 236                   );
 237                 if ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 238                     $Codetype = $RowSearch['code_type'];
 239                     $Code = $RowSearch['code'];
 240                     $Modifier = $RowSearch['modifier'];
 241                 } else {
 242                     $Codetype = '';
 243                     $Code = '';
 244                     $Modifier = '';
 245                 }
 246
 247                 //----------------------------------------------------------------------------------------------------
 248                 if ($_REQUEST['radio_type_of_payment'] == 'copay') {//copay saving to ar_session and ar_activity tables
 249                     $session_id = sqlInsert(
 250                         "INSERT INTO ar_session (payer_id,user_id,reference,check_date,deposit_date,pay_total," .
 251                         " global_amount,payment_type,description,patient_id,payment_method,adjustment_code,post_to_date) " .
 252                         " VALUES ('0',?,?,now(),now(),?,'','patient','COPAY',?,?,'patient_payment',now())",
 253                         array($_SESSION['authUserID'], $form_source, $amount, $form_pid, $form_method)
 254                     );
 255
 256                     sqlBeginTrans();
 257                     $sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM       ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
 258                     $insrt_id = sqlInsert(
 259                         "INSERT INTO ar_activity (pid,encounter,sequence_no,code_type,code,modifier,payer_type,post_time,post_user,session_id,pay_amount,account_code)" .
 260                         " VALUES (?,?,?,?,?,?,0,now(),?,?,?,'PCP')",
 261                         array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, $_SESSION['authUserID'], $session_id, $amount)
 262                     );
 263                     sqlCommitTrans();
 264
 265                     frontPayment($form_pid, $enc, $form_method, $form_source, $amount, 0, $timestamp);//insertion to 'payments' table.
 266                 }
 267
 268                 if ($_REQUEST['radio_type_of_payment'] == 'invoice_balance' || $_REQUEST['radio_type_of_payment'] == 'cash') {                //Payment by patient after insurance paid, cash patients similar to do not bill insurance in feesheet.
 269                     if ($_REQUEST['radio_type_of_payment'] == 'cash') {
 270                         sqlStatement(
 271                             "update form_encounter set last_level_closed=? where encounter=? and pid=? ",
 272                             array(4, $enc, $form_pid)
 273                         );
 274                         sqlStatement(
 275                             "update billing set billed=? where encounter=? and pid=?",
 276                             array(1, $enc, $form_pid)
 277                         );
 278                     }
 279
 280                           $adjustment_code = 'patient_payment';
 281                           $payment_id = sqlInsert(
 282                               "insert into ar_session set " .
 283                               "payer_id = ?" .
 284                               ", patient_id = ?" .
 285                               ", user_id = ?" .
 286                               ", closed = ?" .
 287                               ", reference = ?"   .
 288                               ", check_date =  now() , deposit_date = now() " .
 289                               ",  pay_total = ?" .
 290                               ", payment_type = 'patient'" .
 291                               ", description = ?" .
 292                               ", adjustment_code = ?" .
 293                               ", post_to_date = now() " .
 294                               ", payment_method = ?",
 295                               array(0, $form_pid, $_SESSION['authUserID'], 0, $form_source, $amount, $NameNew, $adjustment_code, $form_method)
 296                           );
 297
 298                     //--------------------------------------------------------------------------------------------------------------------
 299
 300                             frontPayment($form_pid, $enc, $form_method, $form_source, 0, $amount, $timestamp);//insertion to 'payments' table.
 301
 302                     //--------------------------------------------------------------------------------------------------------------------
 303
 304                             $resMoneyGot = sqlStatement(
 305                                 "SELECT sum(pay_amount) as PatientPay FROM ar_activity where pid =? and " .
 306                                 "encounter = ? and payer_type = 0 and account_code = 'PCP' AND deleted IS NULL",
 307                                 array($form_pid, $enc)
 308                             );//new fees screen copay gives account_code='PCP'
 309                             $rowMoneyGot = sqlFetchArray($resMoneyGot);
 310                             $Copay = $rowMoneyGot['PatientPay'];
 311
 312                     //--------------------------------------------------------------------------------------------------------------------
 313
 314                             //Looping the existing code and modifier
 315                             $ResultSearchNew = sqlStatement(
 316                                 "SELECT * FROM billing LEFT JOIN code_types ON billing.code_type=code_types.ct_key WHERE code_types.ct_fee=1 " .
 317                                 "AND billing.activity!=0 AND billing.pid =? AND encounter=? ORDER BY billing.code,billing.modifier",
 318                                 array($form_pid, $enc)
 319                             );
 320                     while ($RowSearch = sqlFetchArray($ResultSearchNew)) {
 321                         $Codetype = $RowSearch['code_type'];
 322                         $Code = $RowSearch['code'];
 323                         $Modifier = $RowSearch['modifier'];
 324                         $Fee = $RowSearch['fee'];
 325
 326                         $resMoneyGot = sqlStatement(
 327                             "SELECT sum(pay_amount) as MoneyGot FROM ar_activity where pid = ? AND deleted IS NULL " .
 328                             "and code_type=? and code=? and modifier=? and encounter =? and !(payer_type=0 and account_code='PCP')",
 329                             array($form_pid, $Codetype, $Code, $Modifier, $enc)
 330                         );
 331                         //new fees screen copay gives account_code='PCP'
 332                         $rowMoneyGot = sqlFetchArray($resMoneyGot);
 333                         $MoneyGot = $rowMoneyGot['MoneyGot'];
 334
 335                         $resMoneyAdjusted = sqlStatement(
 336                             "SELECT sum(adj_amount) as MoneyAdjusted FROM ar_activity where " .
 337                             "pid = ? and code_type = ? and code = ? and modifier = ? and encounter = ? AND deleted IS NULL",
 338                             array($form_pid, $Codetype, $Code, $Modifier, $enc)
 339                         );
 340                         $rowMoneyAdjusted = sqlFetchArray($resMoneyAdjusted);
 341                         $MoneyAdjusted = $rowMoneyAdjusted['MoneyAdjusted'];
 342
 343                         $Remainder = $Fee - $Copay - $MoneyGot - $MoneyAdjusted;
 344                         $Copay = 0;
 345                         if (round($Remainder, 2) != 0 && $amount != 0) {
 346                             if ($amount - $Remainder >= 0) {
 347                                 $insert_value = $Remainder;
 348                                 $amount = $amount - $Remainder;
 349                             } else {
 350                                 $insert_value = $amount;
 351                                 $amount = 0;
 352                             }
 353
 354                               sqlBeginTrans();
 355                               $sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
 356                               sqlStatement(
 357                                   "insert into ar_activity set " .
 358                                   "pid = ?" .
 359                                   ", encounter = ?" .
 360                                   ", sequence_no = ?" .
 361                                   ", code_type = ?" .
 362                                   ", code = ?" .
 363                                   ", modifier = ?" .
 364                                   ", payer_type = ?" .
 365                                   ", post_time = now() " .
 366                                   ", post_user = ?" .
 367                                   ", session_id = ?" .
 368                                   ", pay_amount = ?" .
 369                                   ", adj_amount = ?" .
 370                                   ", account_code = 'PP'",
 371                                   array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, 0, $_SESSION['authUserID'], $payment_id, $insert_value, 0)
 372                               );
 373                               sqlCommitTrans();
 374                         }//if
 375                     }//while
 376                     if ($amount != 0) {//if any excess is there.
 377                               sqlBeginTrans();
 378                                 $sequence_no = sqlQuery("SELECT IFNULL(MAX(sequence_no),0) + 1 AS increment FROM ar_activity WHERE pid = ? AND encounter = ?", array($form_pid, $enc));
 379                                 sqlStatement(
 380                                     "insert into ar_activity set " .
 381                                     "pid = ?" .
 382                                     ", encounter = ?" .
 383                                     ", sequence_no = ?" .
 384                                     ", code_type = ?" .
 385                                     ", code = ?" .
 386                                     ", modifier = ?" .
 387                                     ", payer_type = ?" .
 388                                     ", post_time = now() " .
 389                                     ", post_user = ?" .
 390                                     ", session_id = ?" .
 391                                     ", pay_amount = ?" .
 392                                     ", adj_amount = ?" .
 393                                     ", account_code = 'PP'",
 394                                     array($form_pid, $enc, $sequence_no['increment'], $Codetype, $Code, $Modifier, 0, $_SESSION['authUserID'], $payment_id, $amount, 0)
 395                                 );
 396                                 sqlCommitTrans();
 397                     }
 398
 399                     //--------------------------------------------------------------------------------------------------------------------
 400                 }//invoice_balance
 401             }//if ($amount = 0 + $payment)
 402         }//foreach
 403     }//if ($_POST['form_upay'])
 404 }//if ($_POST['form_save'])
 405
 406 if (!empty($_POST['form_save']) || !empty($_REQUEST['receipt'])) {
 407     if (!empty($_REQUEST['receipt'])) {
 408         $form_pid = $_GET['patient'];
 409         $timestamp = decorateString('....-..-.. ..:..:..', $_GET['time']);
 410     }
 411
 412     // Get details for what we guess is the primary facility.
 413     $frow = $facilityService->getPrimaryBusinessEntity(array("useLegacyImplementation" => true));
 414
 415     // Get the patient's name and chart number.
 416     $patdata = getPatientData($form_pid, 'fname,mname,lname,pubpid');
 417
 418     // Re-fetch payment info.
 419     $payrow = sqlQuery("SELECT " .
 420     "SUM(amount1) AS amount1, " .
 421     "SUM(amount2) AS amount2, " .
 422     "MAX(method) AS method, " .
 423     "MAX(source) AS source, " .
 424     "MAX(dtime) AS dtime, " .
 425     // "MAX(user) AS user " .
 426     "MAX(user) AS user, " .
 427     "MAX(encounter) as encounter " .
 428     "FROM payments WHERE " .
 429     "pid = ? AND dtime = ?", array($form_pid, $timestamp));
 430
 431     // Create key for deleting, just in case.
 432     $ref_id = ($_REQUEST['radio_type_of_payment'] == 'copay') ? $session_id : $payment_id;
 433     $payment_key = $form_pid . '.' . preg_replace('/[^0-9]/', '', $timestamp) . '.' . $ref_id;
 434
 435     if ($_REQUEST['radio_type_of_payment'] != 'pre_payment') {
 436         // get facility from encounter
 437         $tmprow = sqlQuery("SELECT `facility_id` FROM `form_encounter` WHERE `encounter` = ?", array($payrow['encounter']));
 438         $frow = $facilityService->getById($tmprow['facility_id']);
 439     } else {
 440         // if pre_payment, then no encounter yet, so get main office address
 441         $frow = $facilityService->getPrimaryBillingLocation();
 442     }
 443
 444     // Now proceed with printing the receipt.
 445     ?>
 446
 447 <title><?php echo xlt('Receipt for Payment'); ?></title>
 448     <?php Header::setupHeader(); ?>
 449 <script>
 450
 451     <?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
 452
 453 $(function () {
 454     var win = top.printLogSetup ? top : opener.top;
 455     win.printLogSetup(document.getElementById('printbutton'));
 456 });
 457
 458 function closeHow(e) {
 459     if (opener) {
 460         dlgclose();
 461         return;
 462     }
 463     top.activateTabByName('pat', true);
 464     top.tabCloseByName(window.name);
 465 }
 466
 467 // This is action to take before printing and is called from restoreSession.php.
 468 function printlog_before_print() {
 469     let divstyle = document.getElementById('hideonprint').style;
 470     divstyle.display = 'none';
 471     // currently exit is not hidden by default in case receipt print is not needed
 472     // and left here for future option to force users to print via global etc..
 473     // can still print later via reports.
 474     divstyle = document.getElementById('showonprint').style;
 475     divstyle.display = '';
 476 }
 477
 478 // Process click on Delete button.
 479 function deleteme() {
 480     dlgopen('deleter.php?payment=' + <?php echo js_url($payment_key); ?> + '&csrf_token_form=' + <?php echo js_url(CsrfUtils::collectCsrfToken()); ?>, '_blank', 500, 450);
 481     return false;
 482 }
 483
 484 // Called by the deleteme.php window on a successful delete.
 485 function imdeleted() {
 486     if (opener) {
 487         dlgclose(); // we're in reports/leftnav and callback reloads.
 488     } else {
 489         window.history.back(); // this is us full screen.
 490     }
 491 }
 492
 493 // Called to switch to the specified encounter having the specified DOS.
 494 // This also closes the popup window.
 495 function toencounter(enc, datestr, topframe) {
 496     top.restoreSession();
 497     top.goToEncounter(enc);
 498     if (opener) dlgclose();
 499 }
 500
 501 </script>
 502 <style>
 503     @media print {
 504         #donebutton {
 505             display: none;
 506         }
 507     }
 508 </style>
 509 </head>
 510 <body>
 511     <div class="container mt-3">
 512         <div class="row">
 513             <div class="col-12 text-center">
 514                 <h2><?php echo xlt('Receipt for Payment'); ?></h2>
 515                 <p>
 516                     <?php echo text($frow['name']) ?>
 517                     <br />
 518                     <?php echo text($frow['street']) ?>
 519                     <br />
 520                     <?php echo text($frow['city'] . ', ' . $frow['state']) . ' ' . text($frow['postal_code']) ?>
 521                     <br />
 522                     <?php echo text($frow['phone']) ?>
 523                 </p>
 524
 525                 <div class="table-responsive">
 526                     <table class="table table-borderless">
 527                         <tr>
 528                             <td><?php echo xlt('Date'); ?>:</td>
 529                             <td><?php echo text(oeFormatSDFT(strtotime($payrow['dtime']))) ?></td>
 530                         </tr>
 531                         <tr>
 532                             <td><?php echo xlt('Patient'); ?>:</td>
 533                             <td><?php echo text($patdata['fname']) . " " . text($patdata['mname']) . " " .
 534                             text($patdata['lname']) . " (" . text($patdata['pubpid']) . ")" ?></td>
 535                         </tr>
 536                         <tr>
 537                             <td><?php echo xlt('How Paid'); ?>:</td>
 538                             <td><?php echo generate_display_field(array('data_type' => '1', 'list_id' => 'payment_method'), $payrow['method']); ?></td>
 539                         </tr>
 540                         <tr>
 541                             <td><?php echo xlt('Check or Reference Number'); ?>:</td>
 542                             <td><?php echo text($payrow['source']) ?></td>
 543                         </tr>
 544                         <tr>
 545                             <td><?php echo xlt('Amount for This Visit'); ?>:</td>
 546                             <td><?php echo text(oeFormatMoney($payrow['amount1'])) ?></td>
 547                         </tr>
 548                         <tr>
 549                             <td>
 550                             <?php
 551                             if ($_REQUEST['radio_type_of_payment'] == 'pre_payment') {
 552                                 echo xlt('Pre-payment Amount');
 553                             } else {
 554                                 echo xlt('Amount for Past Balance');
 555                             }
 556                             ?>
 557                             :</td>
 558                             <td><?php echo text(oeFormatMoney($payrow['amount2'])) ?></td>
 559                         </tr>
 560                         <tr>
 561                             <td><?php echo xlt('Received By'); ?>:</td>
 562                             <td><?php echo text($payrow['user']) ?></td>
 563                         </tr>
 564                     </table>
 565                 </div>
 566                 <div id='hideonprint'>
 567                     <button type="button" class="btn btn-primary btn-print" value='<?php echo xla('Print'); ?>' id='printbutton'>
 568                         <?php echo xlt('Print'); ?>
 569                     </button>
 570
 571                     <?php
 572                     $todaysenc = todaysEncounterIf($pid);
 573                     if ($todaysenc && $todaysenc != $encounter) {
 574                         echo "&nbsp;<input type='button' class='btn btn-primary' " .
 575                         "value='" . xla('Open Today`s Visit') . "' " .
 576                         "onclick='toencounter(" . attr_js($todaysenc) . ", " . attr_js($today) . ", (opener ? opener.top : top))' />\n";
 577                     }
 578                     ?>
 579
 580                     <?php if (AclMain::aclCheckCore('admin', 'super') || AclMain::aclCheckCore('acct', 'bill')) {
 581                         // allowing biller to delete payments ?>
 582                     <button type="button" class="btn btn-danger btn-delete" value='<?php echo xla('Delete'); ?>' onclick="deleteme()">
 583                         <?php echo xlt('Delete'); ?>
 584                     </button>
 585                     <?php } ?>
 586                 </div>
 587                 <div class='mt-3' id='showonprint'>
 588                     <button type="button" class="btn btn-secondary btn-cancel" value='<?php echo xla('Exit'); ?>' id='donebutton' onclick="closeHow(event)">
 589                         <?php echo xlt('Exit'); ?>
 590                     </button>
 591                 </div>
 592             </div>
 593         </div>
 594     </div>
 595 </body>
 596
 597     <?php
 598     //
 599     // End of receipt printing logic.
 600     //
 601 } else {
 602     //
 603     // Here we display the form for data entry.
 604     //
 605     ?>
 606 <title><?php echo xlt('Record Payment'); ?></title>
 607
 608 <style>
 609     #ajax_div_patient {
 610         position: absolute;
 611         z-index:10;
 612         background-color: #FBFDD0;
 613         border: 1px solid #ccc;
 614         padding: 10px;
 615     }
 616 </style>
 617 <!--Removed standard dependencies 12/29/17 as not needed any longer since moved to a tab/frame not popup.-->
 618
 619 <!-- supporting javascript code -->
 620 <script>
 621     var mypcc = '1';
 622 </script>
 623     <?php include_once("{$GLOBALS['srcdir']}/ajax/payment_ajax_jav.inc.php"); ?>
 624 <script>
 625     document.onclick=HideTheAjaxDivs;
 626 </script>
 627
 628     <?php Header::setupAssets('topdialog'); ?>
 629
 630 <script src="<?php echo $GLOBALS['assets_static_relative']; ?>/jquery-creditcardvalidator/jquery.creditCardValidator.js"></script>
 631
 632 <script>
 633     var chargeMsg = <?php echo xlj('Payment was successfully authorized and charged. Thank You.'); ?>;
 634     var publicKey = <?php echo json_encode($cryptoGen->decryptStandard($GLOBALS['gateway_public_key'])); ?>;
 635     var apiKey = <?php echo json_encode($cryptoGen->decryptStandard($GLOBALS['gateway_api_key'])); ?>;
 636 $(function() {
 637     $('#openPayModal').on('show.bs.modal', function () {
 638         let total = $("[name='form_paytotal']").val();
 639         let prepay = $("#form_prepayment").val();
 640         if (Number(total) < 1) {
 641             if (Number(prepay) < 1) {
 642                 let error = <?php echo xlj("Please enter a payment amount"); ?>;
 643                 alert(error);
 644                 return false;
 645             }
 646             total = prepay;
 647         }
 648         $("#form_method").val('credit_card');
 649         $("#payTotal").text(total);
 650         $("#paymentAmount").val(total);
 651     });
 652 });
 653     <?php require($GLOBALS['srcdir'] . "/restoreSession.php"); ?>
 654 function closeHow(e) {
 655     if (opener) {
 656         dlgclose();
 657         return;
 658     }
 659     top.activateTabByName('pat', true);
 660     top.tabCloseByName(window.name);
 661 }
 662 function calctotal() {
 663     var f = document.forms[0];
 664     var total = 0;
 665     for (var i = 0; i < f.elements.length; ++i) {
 666         var elem = f.elements[i];
 667         var ename = elem.name;
 668         if (ename.indexOf('form_upay[') == 0 || ename.indexOf('form_bpay[') == 0) {
 669             if (elem.value.length > 0) total += Number(elem.value);
 670         }
 671     }
 672     f.form_paytotal.value = Number(total).toFixed(2);
 673     return true;
 674 }
 675
 676 function coloring() {
 677     for (var i = 1; ; ++i) {
 678         if (document.getElementById('paying_' + i)) {
 679             paying = document.getElementById('paying_' + i).value * 1;
 680             patient_balance = document.getElementById('duept_' + i).innerHTML * 1;
 681
 682             //balance=document.getElementById('balance_'+i).innerHTML*1;
 683             if (patient_balance > 0 && paying > 0) {
 684                 if (paying > patient_balance) {
 685                    document.getElementById('paying_' + i).style.background = '#FF0000';
 686                 }
 687                 else if (paying < patient_balance) {
 688                     document.getElementById('paying_' + i).style.background = '#99CC00';
 689                 }
 690                 else if (paying == patient_balance) {
 691                     document.getElementById('paying_' + i).style.background = 'var(--white)';
 692                 }
 693             } else {
 694                 document.getElementById('paying_' + i).style.background = 'var(--white)';
 695             }
 696         }
 697         else {
 698             break;
 699         }
 700     }
 701 }
 702
 703 function CheckVisible(MakeBlank) { //Displays and hides the check number text box.
 704     if (document.getElementById('form_method').options[document.getElementById(
 705             'form_method').selectedIndex].value == 'check_payment' || document.getElementById(
 706             'form_method').options[document.getElementById('form_method').selectedIndex]
 707         .value == 'bank_draft') {
 708         document.getElementById('check_number').disabled = false;
 709     } else {
 710         document.getElementById('check_number').disabled = true;
 711     }
 712 }
 713
 714 function validate(notSubmit = false) {
 715     var f = document.forms[0];
 716     let ok = -1;
 717     top.restoreSession();
 718     issue = 'no';
 719     // prevent an empty form submission
 720     let flgempty = true;
 721     for (let i = 0; i < f.elements.length; ++i) {
 722         let ename = f.elements[i].name;
 723         if (f.elements[i].value == 'pre_payment' && f.elements[i].checked === true) {
 724             if (Number(f.elements.namedItem("form_prepayment").value) !== 0) {
 725                 flgempty = false;
 726             }
 727             break;
 728         }
 729         if (ename.indexOf('form_upay[') === 0 || ename.indexOf('form_bpay[') === 0) {
 730             if (Number(f.elements[i].value) !== 0) flgempty = false;
 731         }
 732     }
 733     if (flgempty) {
 734         alert(<?php echo xlj('A Payment is Required!. Please input a payment line item entry.'); ?>);
 735         return false;
 736     }
 737     // continue validation.
 738     if (((document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value == 'check_payment' ||
 739             document.getElementById('form_method').options[document.getElementById('form_method').selectedIndex].value == 'bank_draft') &&
 740             document.getElementById('check_number').value == '')) {
 741         alert(<?php echo xlj('Please Fill the Check or Reference Number'); ?>);
 742         document.getElementById('check_number').focus();
 743         return false;
 744     }
 745     if (document.getElementById('radio_type_of_payment_self1').checked == false &&
 746         document.getElementById('radio_type_of_payment1').checked == false &&
 747         document.getElementById('radio_type_of_payment2').checked == false &&
 748         document.getElementById('radio_type_of_payment4').checked == false) {
 749         alert(<?php echo xlj('Please Select Type Of Payment.'); ?>);
 750         return false;
 751     }
 752     if (document.getElementById('radio_type_of_payment_self1').checked == true ||
 753         document.getElementById('radio_type_of_payment1').checked == true) {
 754         for (var i = 0; i < f.elements.length; ++i) {
 755             var elem = f.elements[i];
 756             var ename = elem.name;
 757             if (ename.indexOf('form_upay[0') == 0) //Today is this text box.
 758             {
 759                 if (elem.value * 1 > 0) {//A warning message, if the amount is posted with out encounter.
 760                     if (confirm(<?php echo xlj('If patient has appointment click OK to create encounter otherwise, cancel this and then create an encounter for today visit.'); ?>)) {
 761                         ok = 2;
 762                     } else {
 763                         elem.focus();
 764                         return false;
 765                     }
 766                 }
 767                 break;
 768             }
 769         }
 770     }
 771
 772     if (document.getElementById('radio_type_of_payment1').checked == true){//CO-PAY
 773         var total = 0;
 774         for (var i = 0; i < f.elements.length; ++i) {
 775             var elem = f.elements[i];
 776             var ename = elem.name;
 777             if (ename.indexOf('form_upay[0]') == 0) {//Today is this text box.
 778                 if (f.form_paytotal.value * 1 != elem.value * 1) {//Total CO-PAY is not posted against today
 779                 //A warning message, if the amount is posted against an old encounter.
 780                     if (confirm(<?php echo xlj('You are posting against an old encounter?'); ?>)) {
 781                         ok = 1;
 782                     } else {
 783                         elem.focus();
 784                         return false;
 785                     }
 786                 }
 787                 break;
 788             }
 789         }
 790     }//Co Pay
 791     else if (document.getElementById('radio_type_of_payment2').checked == true) {//Invoice Balance
 792         for (var i = 0; i < f.elements.length; ++i) {
 793             var elem = f.elements[i];
 794             var ename = elem.name;
 795             if (ename.indexOf('form_upay[0') == 0) {
 796                 if (elem.value * 1 > 0) {
 797                     alert(<?php echo xlj('Invoice Balance cannot be posted. No Encounter is created.'); ?>);
 798                     return false;
 799                 }
 800                 break;
 801             }
 802         }
 803     }
 804     if (notSubmit) {
 805         return true;
 806     }
 807     if (ok === -1) {
 808         if (confirm(<?php echo xlj('Would you like to save?'); ?>)) {
 809             return true;
 810         }
 811         else {
 812             return false;
 813         }
 814     }
 815     return ok;
 816 }
 817
 818 function cursor_pointer() { //Point the cursor to the latest encounter(Today)
 819     var f = document.forms[0];
 820     var total = 0;
 821     for (var i = 0; i < f.elements.length; ++i) {
 822         var elem = f.elements[i];
 823         var ename = elem.name;
 824         if (ename.indexOf('form_upay[') == 0) {
 825             elem.focus();
 826             break;
 827         }
 828     }
 829 }
 830 //=====================================================
 831 function make_it_hide_enc_pay() {
 832     document.getElementById('td_head_insurance_payment').style.display = "none";
 833     document.getElementById('td_head_patient_co_pay').style.display = "none";
 834     document.getElementById('td_head_co_pay').style.display = "none";
 835     document.getElementById('td_head_insurance_balance').style.display = "none";
 836     for (var i = 1; ; ++i) {
 837         var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
 838         var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
 839         var td_copay_elem = document.getElementById('td_copay_' + i)
 840         var balance_elem = document.getElementById('balance_' + i)
 841         if (td_inspaid_elem) {
 842             td_inspaid_elem.style.display = "none";
 843             td_patient_copay_elem.style.display = "none";
 844             td_copay_elem.style.display = "none";
 845             balance_elem.style.display = "none";
 846         } else {
 847             break;
 848         }
 849     }
 850     document.getElementById('td_total_4').style.display = "none";
 851     document.getElementById('td_total_7').style.display = "none";
 852     document.getElementById('td_total_8').style.display = "none";
 853     document.getElementById('td_total_6').style.display = "none";
 854     document.getElementById('table_display').width = "420px";
 855 }
 856 //=====================================================
 857 function make_visible() {
 858     document.getElementById('td_head_rep_doc').style.display = "";
 859     document.getElementById('td_head_description').style.display = "";
 860     document.getElementById('td_head_total_charge').style.display = "none";
 861     document.getElementById('td_head_insurance_payment').style.display = "none";
 862     document.getElementById('td_head_patient_payment').style.display = "none";
 863     document.getElementById('td_head_patient_co_pay').style.display = "none";
 864     document.getElementById('td_head_co_pay').style.display = "none";
 865     document.getElementById('td_head_insurance_balance').style.display = "none";
 866     document.getElementById('td_head_patient_balance').style.display = "none";
 867     for (var i = 1; ; ++i) {
 868         var td_charges_elem = document.getElementById('td_charges_' + i)
 869         var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
 870         var td_ptpaid_elem = document.getElementById('td_ptpaid_' + i)
 871         var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
 872
 873         var td_copay_elem = document.getElementById('td_copay_' + i)
 874         var balance_elem = document.getElementById('balance_' + i)
 875         var duept_elem = document.getElementById('duept_' + i)
 876         if (td_charges_elem) {
 877             td_charges_elem.style.display = "none";
 878             td_inspaid_elem.style.display = "none";
 879             td_ptpaid_elem.style.display = "none";
 880             td_patient_copay_elem.style.display = "none";
 881             td_copay_elem.style.display = "none";
 882             balance_elem.style.display = "none";
 883             duept_elem.style.display = "none";
 884         } else {
 885             break;
 886         }
 887     }
 888     document.getElementById('td_total_7').style.display = "";
 889     document.getElementById('td_total_8').style.display = "";
 890     document.getElementById('td_total_1').style.display = "none";
 891     document.getElementById('td_total_2').style.display = "none";
 892     document.getElementById('td_total_3').style.display = "none";
 893     document.getElementById('td_total_4').style.display = "none";
 894     document.getElementById('td_total_5').style.display = "none";
 895     document.getElementById('td_total_6').style.display = "none";
 896     document.getElementById('table_display').width = "505px";
 897 }
 898
 899 function make_it_hide() {
 900     document.getElementById('td_head_rep_doc').style.display = "none";
 901     document.getElementById('td_head_description').style.display = "none";
 902     document.getElementById('td_head_total_charge').style.display = "";
 903     document.getElementById('td_head_insurance_payment').style.display = "";
 904     document.getElementById('td_head_patient_payment').style.display = "";
 905     document.getElementById('td_head_patient_co_pay').style.display = "";
 906     document.getElementById('td_head_co_pay').style.display = "";
 907     document.getElementById('td_head_insurance_balance').style.display = "";
 908     document.getElementById('td_head_patient_balance').style.display = "";
 909     for (var i = 1; ; ++i) {
 910         var td_charges_elem = document.getElementById('td_charges_' + i)
 911         var td_inspaid_elem = document.getElementById('td_inspaid_' + i)
 912         var td_ptpaid_elem = document.getElementById('td_ptpaid_' + i)
 913         var td_patient_copay_elem = document.getElementById('td_patient_copay_' + i)
 914
 915         var td_copay_elem = document.getElementById('td_copay_' + i)
 916         var balance_elem = document.getElementById('balance_' + i)
 917         var duept_elem = document.getElementById('duept_' + i)
 918         if (td_charges_elem) {
 919             td_charges_elem.style.display = "";
 920             td_inspaid_elem.style.display = "";
 921             td_ptpaid_elem.style.display = "";
 922             td_patient_copay_elem.style.display = "";
 923             td_copay_elem.style.display = "";
 924             balance_elem.style.display = "";
 925             duept_elem.style.display = "";
 926         } else {
 927             break;
 928         }
 929     }
 930     document.getElementById('td_total_1').style.display = "";
 931     document.getElementById('td_total_2').style.display = "";
 932     document.getElementById('td_total_3').style.display = "";
 933     document.getElementById('td_total_4').style.display = "";
 934     document.getElementById('td_total_5').style.display = "";
 935     document.getElementById('td_total_6').style.display = "";
 936     document.getElementById('td_total_7').style.display = "";
 937     document.getElementById('td_total_8').style.display = "";
 938     document.getElementById('table_display').width = "635px";
 939 }
 940
 941 function make_visible_radio() {
 942     document.getElementById('tr_radio1').style.display = "";
 943     document.getElementById('tr_radio2').style.display = "none";
 944 }
 945
 946 function make_hide_radio() {
 947     document.getElementById('tr_radio1').style.display = "none";
 948     document.getElementById('tr_radio2').style.display = "";
 949 }
 950
 951 function make_visible_row() {
 952     document.getElementById('table_display').style.display = "";
 953     document.getElementById('table_display_prepayment').style.display = "none";
 954 }
 955
 956 function make_hide_row() {
 957     document.getElementById('table_display').style.display = "none";
 958     document.getElementById('table_display_prepayment').style.display = "";
 959 }
 960
 961 function make_self() {
 962     make_visible_row();
 963     make_it_hide();
 964     make_it_hide_enc_pay();
 965     document.getElementById('radio_type_of_payment_self1').checked = true;
 966     cursor_pointer();
 967 }
 968
 969 function make_insurance() {
 970     make_visible_row();
 971     make_it_hide();
 972     cursor_pointer();
 973     document.getElementById('radio_type_of_payment1').checked = true;
 974 }
 975 </script>
 976
 977 <style>
 978 @media (min-width: 992px) {
 979     .modal-lg {
 980         width: 1000px !Important;
 981     }
 982 }
 983 </style>
 984 <title><?php echo xlt('Record Payment'); ?></title>
 985     <?php $NameNew = $patdata['fname'] . " " . $patdata['lname'] . " " . $patdata['mname']; ?>
 986     <?php
 987     $arrOeUiSettings = array(
 988     'heading_title' => xl('Accept Payment'),
 989     'include_patient_name' => true,// use only in appropriate pages
 990     'expandable' => false,
 991     'expandable_files' => array(),//all file names need suffix _xpd
 992     'action' => "",//conceal, reveal, search, reset, link or back
 993     'action_title' => "",
 994     'action_href' => "",//only for actions - reset, link or back
 995     'show_help_icon' => false,
 996     'help_file_name' => ""
 997     );
 998     $oemr_ui = new OemrUI($arrOeUiSettings);
 999     ?>
1000 </head>
1001 <body>
1002     <div class="container mt-3"><!--begin container div for form-->
1003         <div class="row">
1004             <div class="col-sm-12">
1005                 <?php echo  $oemr_ui->pageHeading() . "\r\n"; ?>
1006             </div>
1007         </div>
1008         <div class="row">
1009             <div class="col-sm-12">
1010                 <form class="form form-vertical" method='post' action='front_payment.php<?php echo (!empty($payid)) ? "?payid=" . attr_url($payid) : ""; ?>' onsubmit='return validate();'>
1011                     <input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" />
1012                     <input name='form_pid' type='hidden' value='<?php echo attr($pid) ?>' />
1013                     <fieldset>
1014                         <legend><?php echo xlt('Payment'); ?></legend>
1015                         <div class="col-12 oe-custom-line">
1016                             <label class="control-label" for="form_method"><?php echo xlt('Payment Method'); ?>:</label>
1017                             <select class="form-control" id="form_method" name="form_method" onchange='CheckVisible("yes")'>
1018                                 <?php
1019                                 $query1112 = "SELECT * FROM list_options where activity=1 AND list_id=?  ORDER BY seq, title ";
1020                                 $bres1112 = sqlStatement($query1112, array('payment_method'));
1021                                 while ($brow1112 = sqlFetchArray($bres1112)) {
1022                                     if ($brow1112['option_id'] == 'electronic' || $brow1112['option_id'] == 'bank_draft') {
1023                                         continue;
1024                                     }
1025                                     echo "<option value='" . attr($brow1112['option_id']) . "'>" . text(xl_list_label($brow1112['title'])) . "</option>";
1026                                 }
1027                                 ?>
1028                             </select>
1029                         </div>
1030                         <div class="col-12 oe-custom-line">
1031                             <label class="control-label" for="check_number"><?php echo xlt('Check or Reference Number'); ?>:</label>
1032                             <div id="ajax_div_patient" style="display:none;"></div>
1033                             <input type='text' id="check_number" name='form_source' class='form-control' value='<?php echo attr($payrow['source'] ?? ''); ?>' />
1034                         </div>
1035                         <div class="col-12 oe-custom-line">
1036                             <label class="control-label" for="form_discount"><?php echo xla('Patient Coverage'); ?>:</label>
1037                             <div class="pl-3">
1038                                 <label class="radio-inline">
1039                                     <input id="radio_type_of_coverage1" name="radio_type_of_coverage" onclick="make_visible_radio();make_self();" type="radio" value="self"><?php echo xlt('Self'); ?>
1040                                 </label>
1041                                 <label class="radio-inline">
1042                                     <input checked="checked" id="radio_type_of_coverag2" name="radio_type_of_coverage" onclick="make_hide_radio();make_insurance();" type="radio" value="insurance"><?php echo xlt('Insurance'); ?>
1043                                 </label>
1044                             </div>
1045                         </div>
1046                         <div class="col-12 oe-custom-line">
1047                             <label class="control-label" for=""><?php echo xlt('Payment against'); ?>:</label>
1048                             <div id="tr_radio1" style="padding-left:15px; display:none"><!-- For radio Insurance -->
1049                                 <label class="radio-inline">
1050                                   <input id="radio_type_of_payment_self1" name="radio_type_of_payment" onclick="make_visible_row();make_it_hide_enc_pay();cursor_pointer();" type="radio" value="cash"><?php echo xlt('Encounter Payment'); ?>
1051                                 </label>
1052                             </div>
1053                             <div id="tr_radio2" style="padding-left:15px"><!-- For radio self -->
1054                                 <label class="radio-inline">
1055                                   <input checked="checked" id="radio_type_of_payment1" name="radio_type_of_payment" onclick="make_visible_row();cursor_pointer();" type="radio" value="copay"><?php echo xlt('Co Pay'); ?>
1056                                 </label>
1057                                 <label class="radio-inline">
1058                                   <input id="radio_type_of_payment2" name="radio_type_of_payment" onclick="make_visible_row();" type="radio" value="invoice_balance"><?php echo xlt('Invoice Balance'); ?><br />
1059                                 </label>
1060                                 <label class="radio-inline">
1061                                   <input id="radio_type_of_payment4" name="radio_type_of_payment" onclick="make_hide_row();" type="radio" value="pre_payment"><?php echo xlt('Pre Pay'); ?>
1062                                 </label>
1063                             </div>
1064                         </div>
1065                         <div class="col-12 oe-custom-line">
1066                             <div id="table_display_prepayment" style="display:none">
1067                                 <label class="control-label" for="form_prepayment"><?php echo xlt('Pre Payment'); ?>:</label>
1068                                 <input name='form_prepayment' id='form_prepayment'class='form-control' type='text' value ='' />
1069                             </div>
1070                         </div>
1071                     </fieldset>
1072                     <fieldset>
1073                         <legend><?php echo xlt('Collect For'); ?></legend>
1074                         <div class="table-responsive">
1075                             <table class="table" id="table_display">
1076                                 <thead>
1077                                     <tr class="table-active" id="tr_head">
1078                                         <th class="font-weight-bold" width="70"><?php echo xlt('DOS'); ?></td>
1079                                         <th class="font-weight-bold" width="65"><?php echo xlt('Encounter'); ?></td>
1080                                         <th class="font-weight-bold text-center" id="td_head_total_charge" width="80"><?php echo xlt('Total Charge'); ?></td>
1081                                         <th class="font-weight-bold text-center" id="td_head_rep_doc" style='display:none' width="70"><?php echo xlt('Report/ Form'); ?></td>
1082                                         <th class="font-weight-bold text-center" id="td_head_description" style='display:none' width="200"><?php echo xlt('Description'); ?></td>
1083                                         <th class="font-weight-bold text-center" id="td_head_insurance_payment" width="80"><?php echo xlt('Insurance Payment'); ?></td>
1084                                         <th class="font-weight-bold text-center" id="td_head_patient_payment" width="80"><?php echo xlt('Patient Payment'); ?></td>
1085                                         <th class="font-weight-bold text-center" id="td_head_patient_co_pay" width="55"><?php echo xlt('Co Pay Paid'); ?></td>
1086                                         <th class="font-weight-bold text-center" id="td_head_co_pay" width="55"><?php echo xlt('Required Co Pay'); ?></td>
1087                                         <th class="font-weight-bold text-center" id="td_head_insurance_balance" width="80"><?php echo xlt('Insurance Balance'); ?></td>
1088                                         <th class="font-weight-bold text-center" id="td_head_patient_balance" width="80"><?php echo xlt('Patient Balance'); ?></td>
1089                                         <th class="font-weight-bold text-center" width="50"><?php echo xlt('Paying'); ?></th>
1090                                     </tr>
1091                                 </thead>
1092                                 <?php
1093                                 $encs = array();
1094
1095                                 // Get the unbilled service charges and payments by encounter for this patient.
1096                                 //
1097                                 $query = "SELECT fe.encounter, b.code_type, b.code, b.modifier, b.fee, " .
1098                                 "LEFT(fe.date, 10) AS encdate ,fe.last_level_closed " .
1099                                 "FROM  form_encounter AS fe left join billing AS b  on " .
1100                                 "b.pid = ? AND b.activity = 1  AND " . //AND b.billed = 0
1101                                 "b.code_type != 'TAX' AND b.fee != 0 " .
1102                                 "AND fe.pid = b.pid AND fe.encounter = b.encounter " .
1103                                 "where fe.pid = ? " .
1104                                 "ORDER BY b.encounter";
1105                                 $bres = sqlStatement($query, array($pid, $pid));
1106                                 //
1107                                 while ($brow = sqlFetchArray($bres)) {
1108                                     $key = 0 - $brow['encounter'];
1109                                     if (empty($encs[$key])) {
1110                                         $encs[$key] = array(
1111                                         'encounter' => $brow['encounter'],
1112                                         'date' => $brow['encdate'],
1113                                         'last_level_closed' => $brow['last_level_closed'],
1114                                         'charges' => 0,
1115                                         'payments' => 0);
1116                                     }
1117
1118                                     if ($brow['code_type'] === 'COPAY') {
1119                                         //$encs[$key]['payments'] -= $brow['fee'];
1120                                     } else {
1121                                         $encs[$key]['charges'] += $brow['fee'];
1122                                         // Add taxes.
1123                                         $sql_array = array();
1124                                         $query = "SELECT taxrates FROM codes WHERE " .
1125                                         "code_type = ? AND " .
1126                                         "code = ? AND ";
1127                                         array_push($sql_array, ($code_types[$brow['code_type']]['id'] ?? null), $brow['code']);
1128                                         if ($brow['modifier']) {
1129                                             $query .= "modifier = ?";
1130                                             array_push($sql_array, $brow['modifier']);
1131                                         } else {
1132                                             $query .= "(modifier IS NULL OR modifier = '')";
1133                                         }
1134
1135                                         $query .= " LIMIT 1";
1136                                         $trow = sqlQuery($query, $sql_array);
1137                                         $encs[$key]['charges'] += calcTaxes($trow, $brow['fee']);
1138                                     }
1139                                 }
1140
1141                                 // Do the same for unbilled product sales.
1142                                 //
1143                                 $query = "SELECT fe.encounter, s.drug_id, s.fee, " .
1144                                 "LEFT(fe.date, 10) AS encdate,fe.last_level_closed " .
1145                                 "FROM form_encounter AS fe left join drug_sales AS s " .
1146                                 "on s.pid = ? AND s.fee != 0 " . //AND s.billed = 0
1147                                 "AND fe.pid = s.pid AND fe.encounter = s.encounter " .
1148                                 "where fe.pid = ? " .
1149                                 "ORDER BY s.encounter";
1150
1151                                 $dres = sqlStatement($query, array($pid, $pid));
1152                                 //
1153                                 while ($drow = sqlFetchArray($dres)) {
1154                                     $key = 0 - $drow['encounter'];
1155                                     if (empty($encs[$key])) {
1156                                         $encs[$key] = array(
1157                                         'encounter' => $drow['encounter'],
1158                                         'date' => $drow['encdate'],
1159                                         'last_level_closed' => $drow['last_level_closed'],
1160                                         'charges' => 0,
1161                                         'payments' => 0);
1162                                     }
1163
1164                                     $encs[$key]['charges'] += $drow['fee'];
1165                                     // Add taxes.
1166                                     $trow = sqlQuery("SELECT taxrates FROM drug_templates WHERE drug_id = ? " .
1167                                     "ORDER BY selector LIMIT 1", array($drow['drug_id']));
1168                                     $encs[$key]['charges'] += calcTaxes($trow, $drow['fee']);
1169                                 }
1170
1171                                 ksort($encs, SORT_NUMERIC);
1172                                 $gottoday = false;
1173                                 //Bringing on top the Today always
1174                                 foreach ($encs as $key => $value) {
1175                                     $dispdate = $value['date'];
1176                                     if (strcmp($dispdate, $today) == 0 && !$gottoday) {
1177                                         $gottoday = true;
1178                                         break;
1179                                     }
1180                                 }
1181
1182                                 // If no billing was entered yet for today, then generate a line for
1183                                 // entering today's co-pay.
1184                                 //
1185                                 if (!$gottoday) {
1186                                     echoLine("form_upay[0]", date("Y-m-d"), 0, 0, 0, 0 /*$duept*/);//No encounter yet defined.
1187                                 }
1188
1189                                 $gottoday = false;
1190                                 foreach ($encs as $key => $value) {
1191                                     $enc = $value['encounter'];
1192                                     $dispdate = $value['date'];
1193                                     if (strcmp($dispdate, $today) == 0 && !$gottoday) {
1194                                         $dispdate = date("Y-m-d");
1195                                         $gottoday = true;
1196                                     }
1197                                     //------------------------------------------------------------------------------------
1198                                     $inscopay = BillingUtilities::getCopay($pid, $dispdate);
1199                                     $patcopay = BillingUtilities::getPatientCopay($pid, $enc);
1200                                     //Insurance Payment
1201                                     //-----------------
1202                                     $drow = sqlQuery(
1203                                         "SELECT  SUM(pay_amount) AS payments, " .
1204                                         "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " .
1205                                         "deleted IS NULL AND pid = ? and encounter = ? and " .
1206                                         "payer_type != 0 and account_code!='PCP' ",
1207                                         array($pid, $enc)
1208                                     );
1209                                     $dpayment = $drow['payments'];
1210                                     $dadjustment = $drow['adjustments'];
1211                                     //Patient Payment
1212                                     //---------------
1213                                     $drow = sqlQuery(
1214                                         "SELECT  SUM(pay_amount) AS payments, " .
1215                                         "SUM(adj_amount) AS adjustments  FROM ar_activity WHERE " .
1216                                         "deleted IS NULL AND pid = ? and encounter = ? and " .
1217                                         "payer_type = 0 and account_code!='PCP' ",
1218                                         array($pid, $enc)
1219                                     );
1220                                     $dpayment_pat = $drow['payments'];
1221
1222                                     //------------------------------------------------------------------------------------
1223                                     //NumberOfInsurance
1224                                     $ResultNumberOfInsurance = sqlStatement("SELECT COUNT( DISTINCT TYPE ) NumberOfInsurance FROM insurance_data
1225                                     where pid = ? and provider>0 ", array($pid));
1226                                     $RowNumberOfInsurance = sqlFetchArray($ResultNumberOfInsurance);
1227                                     $NumberOfInsurance = $RowNumberOfInsurance['NumberOfInsurance'] * 1;
1228                                     //------------------------------------------------------------------------------------
1229                                     $duept = 0;
1230                                     if ((($NumberOfInsurance == 0 || $value['last_level_closed'] == 4 || $NumberOfInsurance == $value['last_level_closed']))) {//Patient balance
1231                                         $brow = sqlQuery("SELECT SUM(fee) AS amount FROM billing WHERE " .
1232                                             "pid = ? and encounter = ? AND activity = 1", array($pid, $enc));
1233                                         $srow = sqlQuery("SELECT SUM(fee) AS amount FROM drug_sales WHERE " .
1234                                             "pid = ? and encounter = ? ", array($pid, $enc));
1235                                         $drow = sqlQuery("SELECT SUM(pay_amount) AS payments, " .
1236                                             "SUM(adj_amount) AS adjustments FROM ar_activity WHERE " .
1237                                             "deleted IS NULL AND pid = ? and encounter = ? ", array($pid, $enc));
1238                                         $duept = $brow['amount'] + $srow['amount'] - $drow['payments'] - $drow['adjustments'];
1239                                     }
1240
1241                                     echoLine(
1242                                         "form_upay[$enc]",
1243                                         $dispdate,
1244                                         $value['charges'],
1245                                         $dpayment_pat,
1246                                         ($dpayment + $dadjustment),
1247                                         $duept,
1248                                         $enc,
1249                                         $inscopay,
1250                                         $patcopay
1251                                     );
1252                                 }
1253                                 // Continue with display of the data entry form.
1254                                 ?>
1255
1256                                 <tr class="table-active">
1257                                     <td class="font-weight-bold" id='td_total_1'></td>
1258                                     <td class="font-weight-bold" id='td_total_2'></td>
1259                                     <td class="font-weight-bold" id='td_total_3'></td>
1260                                     <td class="font-weight-bold" id='td_total_4'></td>
1261                                     <td class="font-weight-bold" id='td_total_5'></td>
1262                                     <td class="font-weight-bold" id='td_total_6'></td>
1263                                     <td class="font-weight-bold" id='td_total_7'></td>
1264                                     <td class="font-weight-bold" id='td_total_8'></td>
1265                                     <td class="font-weight-bold text-right"><?php echo xlt('Total');?></td>
1266                                     <td class="font-weight-bold text-right">
1267                                         <input type='text' class='form-control text-success' name='form_paytotal' value='' readonly />
1268                                     </td>
1269                                 </tr>
1270                             </table>
1271                         </div>
1272                     </fieldset>
1273                     <div class="form-group">
1274                         <div class="col-sm-12 text-left position-override">
1275                             <div class="form-group" role="group">
1276                                 <button type='submit' class="btn btn-primary btn-save" name='form_save' value='<?php echo xla('Generate Invoice');?>'><?php echo xlt('Generate Invoice');?></button>
1277                                 <?php if (!empty($GLOBALS['cc_front_payments']) && $GLOBALS['payment_gateway'] != 'InHouse') {
1278                                     if ($GLOBALS['payment_gateway'] == 'Sphere') {
1279                                         echo SpherePayment::renderSphereHtml('clinic');
1280                                     } else {
1281                                         echo '<button type="button" class="btn btn-success btn-transmit mx-1" data-toggle="modal" data-target="#openPayModal">' . xlt("Credit Card Pay") . '</button>';
1282                                         if (!empty($GLOBALS['cc_stripe_terminal'])) {
1283                                             echo '<button type="button" class="btn btn-success btn-transmit mx-1" onclick="posDialog()">' . xlt("POS Payment") . '</button>';
1284                                         }
1285                                     }
1286                                 }  ?>
1287                                 <button type='button' class="btn btn-secondary btn-cancel" value='<?php echo xla('Cancel'); ?>' onclick='closeHow(event)'><?php echo xlt('Cancel'); ?></button>
1288                                 <input type="hidden" name="hidden_patient_code" id="hidden_patient_code" value="<?php echo attr($pid);?>"/>
1289                                 <input type='hidden' name='ajax_mode' id='ajax_mode' value='' />
1290                                 <input type='hidden' name='mode' id='mode' value='' />
1291                             </div>
1292                         </div>
1293                     </div>
1294                 </form>
1295             </div>
1296         </div>
1297         <script>
1298         calctotal();
1299         </script>
1300         <!-- credit payment modal -->
1301         <div id="openPayModal" class="modal fade" role="dialog">
1302             <div class="modal-dialog">
1303                 <div class="modal-content">
1304                     <div class="modal-header">
1305                         <h4><?php echo xlt('Submit Payment for Authorization'); ?></h4>
1306                     </div>
1307                     <div class="modal-body">
1308                         <?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') { ?>
1309                             <form id='paymentForm' method='post' action='./front_payment_cc.php'>
1310                                 <fieldset>
1311                                     <div class="form-group">
1312                                         <label
1313                                             class="control-label"><?php echo xlt('Name on Card'); ?></label>
1314                                         <div class="controls">
1315                                             <input name="cardHolderName" id="cardHolderName" type="text" class="form-control"
1316                                                 pattern="\w+ \w+.*"
1317                                                 title="<?php echo xla('Fill your first and last name'); ?>"
1318                                                 value="<?php echo attr($patdata['fname']) . ' ' . attr($patdata['lname']) ?>" />
1319                                         </div>
1320                                     </div>
1321                                     <div class="form-group">
1322                                         <div class="row">
1323                                             <div class="col-sm-6">
1324                                                 <label class="control-label"><?php echo xlt('Card Number'); ?></label>
1325                                                 <input name="cardNumber" id="cardNumber" type="text"
1326                                                     class="form-control"
1327                                                     autocomplete="off" maxlength="19" pattern="\d"
1328                                                     onchange="validateCC()"
1329                                                     title="<?php echo xla('Card Number'); ?>" value="" />&nbsp;&nbsp;
1330                                             </div>
1331                                             <span class="col-sm-6">
1332                                                     <label class="control-label"><?php echo xlt('Entry Status'); ?></label>
1333                                                     <h5 name="cardtype" id="cardtype" style="color:#cc0000;"><?php echo xlt('Validating') ?></h5>
1334                                                 </span>
1335                                         </div>
1336                                     </div>
1337                                     <div class="form-group">
1338                                         <label
1339                                             class="control-label"><?php echo xlt('Card Expiry Date and Card Holders Zip'); ?></label>
1340                                         <div class="row">
1341                                             <div class="col-md-4">
1342                                                 <select name="month" id="expMonth" class="form-control">
1343                                                     <option value=""><?php echo xlt('Select Month'); ?></option>
1344                                                     <option value="01"><?php echo xlt('January'); ?></option>
1345                                                     <option value="02"><?php echo xlt('February'); ?></option>
1346                                                     <option value="03"><?php echo xlt('March'); ?></option>
1347                                                     <option value="04"><?php echo xlt('April'); ?></option>
1348                                                     <option value="05"><?php echo xlt('May'); ?></option>
1349                                                     <option value="06"><?php echo xlt('June'); ?></option>
1350                                                     <option value="07"><?php echo xlt('July'); ?></option>
1351                                                     <option value="08"><?php echo xlt('August'); ?></option>
1352                                                     <option value="09"><?php echo xlt('September'); ?></option>
1353                                                     <option value="10"><?php echo xlt('October'); ?></option>
1354                                                     <option value="11"><?php echo xlt('November'); ?></option>
1355                                                     <option value="12"><?php echo xlt('December'); ?></option>
1356                                                 </select>
1357                                             </div>
1358                                             <div class="col-md-4">
1359                                                 <select name="year" id="expYear" class="form-control">
1360                                                     <option value=""><?php echo xlt('Select Year'); ?></option>
1361                                                     <option value="2021">2021</option>
1362                                                     <option value="2022">2022</option>
1363                                                     <option value="2023">2023</option>
1364                                                     <option value="2024">2024</option>
1365                                                     <option value="2025">2025</option>
1366                                                     <option value="2026">2026</option>
1367                                                     <option value="2027">2027</option>
1368                                                     <option value="2028">2028</option>
1369                                                     <option value="2028">2029</option>
1370                                                     <option value="2028">2030</option>
1371                                                 </select>
1372                                             </div>
1373                                             <div class="col-md-4">
1374                                                 <input name="zip" id="cczip" type="text" class="form-control"
1375                                                     pattern="\d"
1376                                                     title="<?php echo xla('Enter Your Zip'); ?>"
1377                                                     placeholder="<?php echo xla('Card Holder Zip'); ?>"
1378                                                     value="<?php echo attr($patdata['postal_code']) ?>" />
1379                                             </div>
1380                                         </div>
1381                                     </div>
1382                                     <div class="form-group">
1383                                         <label class="control-label"><?php echo xlt('Card CVV'); ?></label>
1384                                         <div class="row">
1385                                             <div class="col-md-3">
1386                                                 <input name="cardCode" id="cardCode" type="text" class="form-control"
1387                                                     autocomplete="off" maxlength="4" onfocus="validateCC()"
1388                                                     title="<?php echo xla('Three or four digits at back of your card'); ?>"
1389                                                     value="" />
1390                                             </div>
1391                                             <div class="col-md-3">
1392                                                 <img src='./../../portal/images/img_cvc.png' style='height: 40px; width: auto'>
1393                                             </div>
1394                                             <div class="col-md-6">
1395                                                 <h4 style="display: inline-block;"><?php echo xlt('Payment Amount'); ?>:&nbsp;
1396                                                     <strong><span id="payTotal"></span></strong></h4>
1397                                             </div>
1398                                         </div>
1399                                     </div>
1400                                     <input type='hidden' name='pid' id='pid' value='<?php echo attr($pid) ?>' />
1401                                     <input type='hidden' name='mode' id='mode' value='' />
1402                                     <input type='hidden' name='cc_type' id='cc_type' value='' />
1403                                     <input type='hidden' name='payment' id='paymentAmount' value='' />
1404                                     <input type='hidden' name='invValues' id='invValues' value='' />
1405                                     <input type="hidden" name="dataValue" id="dataValue" />
1406                                     <input type="hidden" name="dataDescriptor" id="dataDescriptor" />
1407                                 </fieldset>
1408                             </form>
1409                         <?php }
1410                         if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
1411                             <form class="form" method="post" name="payment-form" id="payment-form">
1412                                 <fieldset>
1413                                     <div class="form-group">
1414                                         <label for="cardHolderName" class="control-label"><?php echo xlt('Name on Card'); ?></label>
1415                                         <input name="cardHolderName" id="cardHolderName" type="text"
1416                                             class="form-control"
1417                                             pattern="\w+ \w+.*"
1418                                             title="<?php echo xla('Fill your first and last name'); ?>"
1419                                             value="<?php echo attr($patdata['fname']) . ' ' . attr($patdata['lname']) ?>" />
1420                                     </div>
1421                                     <div class="form-group">
1422                                         <label for="card-element"><?php echo xlt('Credit or Debit Card') ?></label>
1423                                         <div class="form-group" id="card-element"></div>
1424                                         <div class="text-danger" id="card-errors" role="alert"></div>
1425                                     </div>
1426                                     <div class="form-row">
1427                                         <?php echo xlt('Payment Amount'); ?>:&nbsp;<span id="payTotal"></span>
1428                                     </div>
1429                                     <input type='hidden' name='mode' id='mode' value='' />
1430                                     <input type='hidden' name='cc_type' id='cc_type' value='' />
1431                                     <input type='hidden' name='payment' id='paymentAmount' value='' />
1432                                     <input type='hidden' name='invValues' id='invValues' value='' />
1433                                     <input type='hidden' name='encs' id='encs' value='' />
1434                                 </fieldset>
1435                             </form>
1436                         <?php } ?>
1437                     </div>
1438                     <!-- Body  -->
1439                     <div class="modal-footer">
1440                         <div class="button-group">
1441                             <button type="button" class="btn btn-default" data-dismiss="modal"><?php echo xlt('Cancel'); ?></button>
1442                             <?php
1443                             if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') { ?>
1444                                 <button id="payAurhorizeNet" class="btn btn-primary"
1445                                     onclick="sendPaymentDataToAnet(event)"><?php echo xlt('Pay Now'); ?></button>
1446                             <?php }
1447                             if ($GLOBALS['payment_gateway'] == 'Stripe') { ?>
1448                                 <button id="stripeSubmit" class="btn btn-primary"><?php echo xlt('Pay Now'); ?></button>
1449                             <?php } ?>
1450                         </div>
1451                     </div>
1452                 </div>
1453             </div>
1454         </div>
1455
1456         <?php if ($GLOBALS['payment_gateway'] == 'AuthorizeNet') {
1457             // Include Authorize.Net dependency to tokenize card.
1458             // Will return a token to use for payment request keeping
1459             // credit info off the server.
1460             ?>
1461             <script>
1462                 var ccerr = <?php echo xlj('Invalid Credit Card Number'); ?>
1463
1464                     // In House CC number Validation
1465                     $('#cardNumber').validateCreditCard(function (result) {
1466                         var r = (result.card_type === null ? '' : result.card_type.name.toUpperCase())
1467                         var v = (result.valid === true ? ' Valid Number' : ' Validating')
1468                         if (result.valid === true) {
1469                             document.getElementById("cardtype").style.color = "#00aa00";
1470                         } else {
1471                             document.getElementById("cardtype").style.color = "#aa0000";
1472                         }
1473                         $('#cardtype').text(r + v);
1474                     });
1475
1476                 // Authorize.net
1477                 function validateCC() {
1478                     var result = $('#cardNumber').validateCreditCard();
1479                     var r = (result.card_type == null ? '' : result.card_type.name.toUpperCase())
1480                     var v = (result.valid === true ? ' Valid Card Number' : ' Invalid Card Number')
1481                     if (result.valid === true) {
1482                         document.getElementById("cardtype").style.color = "#00aa00";
1483                     } else {
1484                         document.getElementById("cardtype").style.color = "#aa0000";
1485                     }
1486                     $('#cardtype').text(r + v);
1487                     $('#cc_type').val(r);
1488                     if (!result.valid) {
1489                         alert(ccerr);
1490                         return false;
1491                     }
1492                     else {
1493                         return true;
1494                     }
1495                 }
1496
1497                 function sendPaymentDataToAnet(e) {
1498                     e.preventDefault();
1499                     const authData = {};
1500                     authData.clientKey = publicKey;
1501                     authData.apiLoginID = apiKey;
1502
1503                     const cardData = {};
1504                     cardData.cardNumber = document.getElementById("cardNumber").value;
1505                     cardData.month = document.getElementById("expMonth").value;
1506                     cardData.year = document.getElementById("expYear").value;
1507                     cardData.cardCode = document.getElementById("cardCode").value;
1508                     cardData.fullName = document.getElementById("cardHolderName").value;
1509                     cardData.zip = document.getElementById("cczip").value;
1510
1511                     const secureData = {};
1512                     secureData.authData = authData;
1513                     secureData.cardData = cardData;
1514
1515                     Accept.dispatchData(secureData, acceptResponseHandler);
1516
1517                     function acceptResponseHandler(response) {
1518                         if (response.messages.resultCode === "Error") {
1519                             let i = 0;
1520                             let errorMsg = '';
1521                             while (i < response.messages.message.length) {
1522                                 errorMsg = errorMsg + response.messages.message[i].code + ": " +response.messages.message[i].text;
1523                                 console.log(errorMsg);
1524                                 i = i + 1;
1525                             }
1526                             alert(errorMsg);
1527                         } else {
1528                             paymentFormUpdate(response.opaqueData);
1529                         }
1530                     }
1531                 }
1532
1533                 function paymentFormUpdate(opaqueData) {
1534                     // this is card tokenized
1535                     document.getElementById("dataDescriptor").value = opaqueData.dataDescriptor;
1536                     document.getElementById("dataValue").value = opaqueData.dataValue;
1537                     let oForm = document.forms['paymentForm'];
1538                     oForm.elements['mode'].value = "AuthorizeNet";
1539                     // empty out the fields before submitting to server.
1540                     document.getElementById("cardNumber").value = "";
1541                     document.getElementById("expMonth").value = "";
1542                     document.getElementById("expYear").value = "";
1543                     document.getElementById("cardCode").value = "";
1544
1545                     // Submit payment to server
1546                     fetch('./front_payment_cc.php', {
1547                         method: 'POST',
1548                         body: new FormData(oForm)
1549                     }).then((response) => {
1550                         if (!response.ok) {
1551                             throw Error(response.statusText);
1552                         }
1553                         return response.json();
1554                     }).then(function(data) {
1555                         if(data.status !== 'ok') {
1556                             alert(data);
1557                             return;
1558                         }
1559                         document.getElementById("check_number").value = data.authCode;
1560                         alert(chargeMsg + "\n" + 'Auth: ' + data.authCode + ' TransId: ' + data.transId);
1561                         $("[name='form_save']").click();
1562                     }).catch(function(error) {
1563                         alert(error)
1564                     });
1565                 }
1566             </script>
1567         <?php }  // end authorize.net ?>
1568
1569         <?php if ($GLOBALS['payment_gateway'] == 'Stripe') { // Begin Include Stripe ?>
1570             <script>
1571                 // await validation function.
1572                 const waitValidate = async (state = false) => {
1573                     return await validate(state);
1574                 }
1575                 const stripe = Stripe(publicKey);
1576                 const elements = stripe.elements();
1577                 const style = {
1578                     base: {
1579                         color: '#32325d',
1580                         lineHeight: '1.2rem',
1581                         fontSmoothing: 'antialiased',
1582                         '::placeholder': {
1583                             color: '#ccc'
1584                         }
1585                     },
1586                     invalid: {
1587                         color: '#f42c03',
1588                         iconColor: '#ff0000'
1589                     }
1590
1591                 };
1592                 // Create an instance of the card Element.
1593                 const card = elements.create('card', {style: style});
1594                 // Add an instance of the card Element into the `card-element` <div>.
1595                 card.mount('#card-element');
1596                 // Handle real-time validation errors from the card Element.
1597                 card.addEventListener('change', function (event) {
1598                     let displayError = document.getElementById('card-errors');
1599                     if (event.error) {
1600                         displayError.textContent = event.error.message;
1601                     } else {
1602                         displayError.textContent = '';
1603                     }
1604                 });
1605                 // Handle form submission.
1606                 let form = document.getElementById('stripeSubmit');
1607                 form.addEventListener('click', function (event) {
1608                     event.preventDefault();
1609                     stripe.createToken(card).then(function (result) {
1610                         if (result.error) {
1611                             // Inform the user if there was an error.
1612                             let errorElement = document.getElementById('card-errors');
1613                             errorElement.textContent = result.error.message;
1614                         } else {
1615                             // Send the token to server.
1616                             stripeTokenHandler(result.token);
1617                         }
1618                     });
1619                 });
1620
1621                 // Submit the form with the token ID.
1622                 function stripeTokenHandler(token) {
1623                     // below for manual cc audit
1624                     const encDates = (() => {
1625                         let i = 0, c;
1626                         let invDates = '';
1627                         $('#table_display tbody tr').each(function () {
1628                             if (this.className == 'table-active') {
1629                                 return false;
1630                             }
1631                             if(i > 4) {
1632                                 return false; // breaks on max 5 encounters
1633                             }
1634                             invDates += 'item' + ++i + ': ';
1635                             c = 0;
1636                             $(this).find('td').each(function() {
1637                                 if (++c < 3) {
1638                                     invDates += this.innerText + ' ';
1639                                 }
1640                             })
1641                         });
1642                         return invDates;
1643                     })();
1644                     // Insert the token ID into the form so it gets submitted to the server
1645                     let oForm = document.forms['payment-form'];
1646                     oForm.elements['mode'].value = "Stripe";
1647                     oForm.elements['encs'].value = encDates;
1648
1649                     let hiddenInput = document.createElement('input');
1650                     hiddenInput.setAttribute('type', 'hidden');
1651                     hiddenInput.setAttribute('name', 'stripeToken');
1652                     hiddenInput.setAttribute('value', token.id);
1653                     oForm.appendChild(hiddenInput);
1654
1655                     // Submit payment to server
1656                     fetch('./front_payment_cc.php', {
1657                         method: 'POST',
1658                         body: new FormData(oForm)
1659                     }).then((response) => {
1660                         if (!response.ok) {
1661                             throw Error(response.statusText);
1662                         }
1663                         return response.json();
1664                     }).then(function (data) {
1665                         if (data.status !== 'ok') {
1666                             alert(data);
1667                             return;
1668                         }
1669                         document.getElementById("check_number").value = data.transId;
1670                         alert(chargeMsg + "\n" + 'Auth: ' + data.authCode + ' TransId: ' + data.transId);
1671                         $("[name='form_save']").click();
1672                     }).catch(function (error) {
1673                         alert(error.message);
1674                     });
1675                 }
1676                 // terminal
1677                 <?php if (!empty($GLOBALS['cc_stripe_terminal'])) { ?>
1678                 // Dialog function for Stripe terminal payment.
1679                 // Will post on successful credit payment.
1680                 function posDialog() {
1681                     // to pass validation check and saving a user having to click.
1682                     $("#form_method").val('credit_card');
1683                     // let's validate prior to collect payment from terminal
1684                     // we'll use an await and validate promise to proceed.
1685                     waitValidate(true).then((validateOk) => {
1686                         // validation failed for some reason that user is aware
1687                         // by alerts or a quite fail we'll handle.
1688                         if (validateOk === false || typeof validateOk === 'undefined') {
1689                             return false;
1690                         }
1691                         // if 2 then need an encounter so credit is no no!
1692                         // 1 would be posting against old encounter. will allow.
1693                         if (validateOk === 2) {
1694                             alert(xl("Must have an encounter to take credit card payment."));
1695                             return true;
1696                         }
1697                         let total = $("[name='form_paytotal']").val();
1698                         let prepay = $("#form_prepayment").val();
1699                         // just to be sure. validate() should catch...
1700                         if (Number(total) < 1) {
1701                             if (Number(prepay) < 1) {
1702                                 let error = xl("Please enter a payment amount");
1703                                 alert(error);
1704                                 return false;
1705                             }
1706                             total = prepay;
1707                         }
1708                         $("#payTotal").text(total);
1709                         $("#paymentAmount").val(total);
1710                         let title = xl("POS Payment");
1711                         let url = "./front_payment_terminal.php?total=" + encodeURIComponent(total);
1712                         dlgopen(url, 'terminal', 'modal-md', '550', '', title, {
1713                             buttons: [
1714                                 {text: xl('Cancel'), close: false, id: "closeBtn", style: 'secondary btn-cancel'}
1715                             ]
1716                         });
1717                     });
1718                 }
1719                 <?php } ?>
1720             </script>
1721         <?php } ?>
1722
1723         <?php
1724         if ($GLOBALS['payment_gateway'] == 'Sphere') {
1725             echo (new SpherePayment('clinic', $pid))->renderSphereJs();
1726         }
1727         ?>
1728
1729     </div><!--end of container div of accept payment i.e the form-->
1730     <?php
1731         $oemr_ui->oeBelowContainerDiv();
1732 } // forms else close
1733 ?>
1734 </body>
1735 </html>