interface/patient_file/encounter/copay.php

   1 <?php
   2 include_once("../../globals.php");
   3 include_once("$srcdir/sql.inc");
   4
   5 // This may be more appropriate to move to the library
   6 // later
   7 require_once("{$GLOBALS['srcdir']}/sql.inc");
   8 function getInsuranceCompanies($pid) {
   9   $res = sqlStatement("SELECT * FROM insurance_data WHERE pid = '$pid' " .
  10     "ORDER BY type ASC, date DESC");
  11   $prevtype = '';
  12   for($iter = 0; $row = sqlFetchArray($res); $iter++) {
  13     if (strcmp($row['type'], $prevtype) == 0) continue;
  14     $prevtype = $row['type'];
  15     $all[$iter] = $row;
  16   }
  17   return $all;
  18 }
  19
  20 //the number of rows to display before resetting and starting a new column:
  21 $N=10
  22 ?>
  23 <html>
  24 <head>
  25 <?php html_header_show();?>
  26 <link rel="stylesheet" href="<?php echo $css_header;?>" type="text/css">
  27 </head>
  28 <body class="body_bottom">
  29
  30 <table border='0' cellspacing='0' cellpadding='0' height='100%'>
  31 <tr>
  32
  33 <td valign=top>
  34
  35 <dl>
  36
  37 <form method='post' name='copay_form' action="diagnosis.php?mode=add&type=COPAY&text=copay"
  38  target='Diagnosis' onsubmit='return top.restoreSession()'>
  39
  40 <dt><span class=title><?php xl('Copay','e'); ?></span></dt>
  41
  42 <br>
  43 <span class='text'>$ </span><input type='entry' name='code' value='' size='5' />
  44
  45 <input type="SUBMIT" value="<?php xl('Save','e'); ?>"><br><br>
  46
  47 <div<?php if ($GLOBALS['simplified_copay']) echo " style='display:none;'"; ?>>
  48 <input type="RADIO" name="payment_method" value="cash" checked><?php xl('cash','e'); ?>
  49 <input type="RADIO" name="payment_method" value="credit card"><?php xl('credit','e'); ?>
  50 <input type="RADIO" name="payment_method" value="check"><?php xl('check','e'); ?>
  51 <input type="RADIO" name="payment_method" value="other"><?php xl('other','e'); ?><br><br>
  52 <input type="RADIO" name="payment_method" value="insurance"><?php xl('insurance','e'); ?>
  53 <?php
  54 if ($ret=getInsuranceCompanies($pid)) {
  55         if (sizeof($ret)>0) {
  56                 echo "<select name=insurance_company>\n";
  57                 foreach($ret as $iter) {
  58                         $plan_name = trim($iter['plan_name']);
  59                         if ($plan_name != '') {
  60                                 echo "<option value='"
  61                                 .$plan_name
  62                                 ."'>".$plan_name ."\n";
  63                         }
  64                 }
  65                 echo "</select>\n";
  66         }
  67 }
  68 ?>
  69 <br><br>
  70 <input type="RADIO" name="payment_method" value="write off"><?php xl('write off','e'); ?>
  71
  72 </div>
  73
  74 </form>
  75
  76 </dl>
  77
  78 </td>
  79 </tr>
  80 </table>
  81
  82 </body>
  83 </html>