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@@ -1,58 +1,62 @@
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-<section style="padding-top: 0.1rem;">
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-
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- <div style="margin: 0 0 1rem; font-weight: bold; "><span style="font-size: 16px">Specimen/Physician Information</span></div>
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-
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- <table cellpadding="0" cellspacing="0" border="0" style="width: 100%; font-size: 14px; margin-bottom: 1rem;">
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- <tr>
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- <td style="padding-bottom: 0.25rem; width: 20%; opacity: 0.75;">Order Date:</td>
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- <td style="padding-bottom: 0.25rem; width: 30%; opacity: 0.75; font-weight: bold;">{{date('Y-m-d h:i a')}}</td>
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- <td style="padding-bottom: 0.25rem; width: 20%; opacity: 0.75;">NPI:</td>
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- <td style="padding-bottom: 0.25rem; width: 30%; opacity: 0.75; font-weight: bold;">{{$prescription->hcpPro->hcp_npi}}</td>
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- </tr>
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- <tr>
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- <td style="padding-bottom: 0.25rem; width: 20%; opacity: 0.75;">Test Date:</td>
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- <td style="padding-bottom: 0.25rem; width: 30%; opacity: 0.75; font-weight: bold;">-</td>
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- <td style="padding-bottom: 0.25rem; width: 20%; opacity: 0.75;">Practice Phone:</td>
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- <td style="padding-bottom: 0.25rem; width: 30%; opacity: 0.75; font-weight: bold;">202-935-1033</td>
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- </tr>
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- <tr>
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- <td style="padding-bottom: 0.25rem; width: 20%; opacity: 0.75;">Ordering Physician:</td>
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- <td style="padding-bottom: 0.25rem; width: 30%; opacity: 0.75; font-weight: bold;">{{$prescription->hcpPro->displayName()}}</td>
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- <td style="padding-bottom: 0.25rem; width: 20%; opacity: 0.75;">Practice Fax:</td>
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- <td style="padding-bottom: 0.25rem; width: 30%; opacity: 0.75; font-weight: bold;">202-935-1033</td>
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- </tr>
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- </table>
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-
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- <table cellpadding="0" cellspacing="0" border="0" style="width: 100%">
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- <tr>
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- <td style="width: 70%">
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- <b>Patient Information</b>
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- </td>
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- <td style="">
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+<?php
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+$addressParts = [];
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+if (!!$patient->mailing_address_line1) $addressParts[] = $patient->mailing_address_line1;
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+if (!!$patient->mailing_address_line2) $addressParts[] = $patient->mailing_address_line2;
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+$addressParts = implode(", ", $addressParts) . ", ";
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+$addressPart2 = [];
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+if (!!$patient->mailing_address_city) $addressPart2[] = $patient->mailing_address_city;
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+if (!!$patient->mailing_address_state) $addressPart2[] = $patient->mailing_address_state;
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+$addressPart2 = implode(", ", $addressPart2);
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- </td>
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- </tr>
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+$coverage = $patient->effectiveClientPrimaryCoverage;
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+$payerName = null;
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+$memberID = null;
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+if($coverage) {
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+ if ($coverage->plan_type == 'MEDICARE') {
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+ $payerName = 'Medicare';
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+ $memberID = $coverage->mcr_number;
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+ };
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+ if ($coverage->plan_type == 'MEDICAID') {
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+ $payerName = $coverage->mcd_payer_name;
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+ $memberID = $coverage->mcd_number;
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+ };
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+ if ($coverage->plan_type == 'COMMERCIAL') {
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+ $payerName = $coverage->commercial_payer_name;
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+ $memberID = $coverage->commercial_member_identifier;
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+ }
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+}
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+?>
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+<section style="padding-top: 0.1rem;">
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+ <table style="width:100%;font-size:14px; margin-bottom:1rem;border-collapse: collapse;table-layout:fixed;">
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+ <tr>
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+ <td style="vertical-align:top;padding: 5px;">
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+ <h4 style="line-height:20px;margin:0;text-transform:uppercase;">{{ $patient->displayName() }}</h4>
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+ <span style="font-size:13px;line-height:20px;display:block">{{$addressParts ?: ''}}</span>
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+ <span style="font-size:13px;line-height:20px;display:block">{{$addressPart2 ?: ''}} {{$patient->mailing_address_zip}}</span>
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+ <span style="font-size:13px;line-height:20px;display:block">Phone: {{$patient->cell_number}}</span>
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+ </td>
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+ <td style="vertical-align:top;padding: 5px;">
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+ <h4 style="line-height:20px;margin:0;">PATIENT INFORMATION</h4>
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+ <span style="font-size:13px;line-height:20px;display:block">DOB: {{friendlier_date($patient->dob)}}</span>
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+ <span style="font-size:13px;line-height:20px;display:block">Age: {{$patient->age_in_years}} years old</span>
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+ <span style="font-size:13px;line-height:20px;display:block">Gender: {{$patient->sex}}</span>
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+ </td>
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+ <td style="vertical-align:top;padding: 5px;">
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+ <h4 style="line-height:20px;margin:0;">INSURANCE</h4>
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+ <span style="font-size:13px;line-height:20px;display:block">{{$payerName}}</span>
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+ <span style="font-size:13px;line-height:20px;display:block">Member ID: {{$memberID}}</span>
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+ <span style="font-size:13px;line-height:20px;display:block">Insurance Contact:</span>
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+ </td>
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+ </tr>
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</table>
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-
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- <div style="font-size: 14px; margin-top: 0.6rem; line-height: 1.4; opacity: 0.6">
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- <span>{{ $patient->displayName() }}, {{$patient->sex}}, {{$patient->age_in_years}} years old</span><br>
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- <?php
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- $addressParts = [];
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- if (!!$patient->mailing_address_line1) $addressParts[] = $patient->mailing_address_line1;
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- if (!!$patient->mailing_address_line2) $addressParts[] = $patient->mailing_address_line2;
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- $addressParts = implode(", ", $addressParts) . ", ";
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- $addressPart2 = [];
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- if (!!$patient->mailing_address_city) $addressPart2[] = $patient->mailing_address_city;
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- if (!!$patient->mailing_address_state) $addressPart2[] = $patient->mailing_address_state;
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- $addressParts .= implode(", ", $addressPart2);
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- ?>
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- <span>{!! $addressParts !!}</span>
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- </div>
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</section>
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+<hr style="margin: 0.5rem 0; border-top-width: 0; border-bottom-width: 1px; border-color: #bbb">
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+
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<?php $clinical = json_decode($prescription->clinical_detail_json); ?>
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<?php if($clinical && @$clinical->items): ?>
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- <div style="margin: 1.5rem 0 1rem; font-weight: bold; opacity: 0.5"><span style="font-size: 24px">R</span><span style="font-size: 16px">x</span></div>
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+ <div style="margin: 1rem 0; font-weight: bold;"><span style="font-size: 28px">R</span><span style="font-size: 20px">x</span></div>
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+ <div style="margin: 1rem 0; font-size:14px;">Date: {{friendlier_date(date('Y-m-d'))}}</div>
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<section style="font-size: 15px;">
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<?php $count = 0; ?>
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<?php foreach ($clinical->items as $item): ?>
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@@ -87,5 +91,3 @@
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<?php endforeach; ?>
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</section>
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<?php endif; ?>
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-
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-
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