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<div style='position:absolute;border:1px solid gray;border-radius:5px;width:900px;height:550px;background:white;z-index:100000;top:50px;left:300px'> <div style='position:relative;border-radius 5px 5px 0px 0px'> <table style='width:100%;border-collapse:collapse'> <tr> <td colspan='2' class="lightGradient" style="border:1px solid lightgray;height:28px;font-size:14px;font-weight:normal;color:gray;border-right:1px solid #f2f2f2"> <img src="images/bullet.gif" width="10px" height="10px"> </img> <b style="font-size:14px;color:red"> <?php if(($_GET['subView'])==='home'){echo "DASHBOARD";}else{echo "PHIC CLAIM DETAILS";}?><?php echo " <b style='font-size:18px'>" . $_GET['search'] ."</b>";?> </b> </td> <td align='center' class="lightGradient" style='width:3%;background:#F2F2F2;border:1px solid lightgray'> <a href='phic_claims.php?search=<?php echo $_GET['search'];?>&view=plist&id=<?php echo $_GET['id'];?>'> <input type='button' name='close' value='X' style='width:25px;font-size:16;font-weight:bold;height:25px'></a> </td> </tr> </table> </div> <div style='padding:5px;position:relative;height:100px;width:98.7%;border:1px solid #fafafa;background:#f4f4f4;border-bottom:1px solid lightgray'> <?php if(isset($_GET['CreateClaim'])){ $isDisable='Disabled'; $isDisableNew='Disabled'; $value='Locked'; $fontColor='lightgray'; $trueShow ='True'; $bgColor ='#F2F2F2'; }else { $isDisable='Disabled'; $isDisableNew='Disabled'; $value='Save Record'; $fontColor='black'; $trueShow ='false'; } ?> <form action='' method='GET'> <?php $transID = mysql_result(mysql_query("SELECT `fv_phic_id` FROM `trans_code` WHERE `fv_phic_id`!=''"),0); ?> <input type='hidden' name='view' value='new'> <input type='hidden' name='subView' value='new'> <input type='hidden' name='transID' value='<?php echo $transID;?>'> <center><table> <tr style='background:#f4f4f4'> <td style='border:0px solid gray'>Date Start:<br> <input <?php echo $isDisable;?> required align='center' id='datepickerA' type='text' name='startdate' value='<?php echo $_GET['sd']?>' style='background:<?php echo $bgColor;?>;font-size:14px;color:<?php $fontColor;?>;text-align:center;width:120px;height:30px;border:1px solid lightgray; border-radius:3px'> </td> <td align = 'center' style='border:0px solid gray;width:10px;background:#f4f4f4'> -<br> </td> <td style='border:0px solid gray'>Date End:<br> <input <?php echo $isDisable;?> required align='center' id='datepicker' type='text' name='enddate' value='<?php echo $_GET['ed']?>' style='background:<?php echo $bgColor;?>;font-size:14px;color:<?php $fontColor;?>;text-align:center;width:120px;height:30px;border:1px solid lightgray; border-radius:3px'> </td> </td> <td align = 'center' style='border:0px solid gray;width:10px;background:#f4f4f4'> <br> </td> <td style='border:0px solid gray'>Select Center:<br> <select <?php echo $isDisable;?> name="selCom" style="width:400px;height:30px;font-size:14px;color:<?php $fontColor;?>;border;1px solid lightgry;border:1px solid lightgray;background:<?php echo $bgColor;?>;border-radius:3px"> <?php $cID=$_GET['comp']; $getCom = mysql_result(mysql_query("SELECT `company_name` FROM `company` WHERE `company_id`='$cID'"),0); ?> <option style="font-size:14px;color:blue;"> <?php echo "<b style='font-size:14px;'>".$getCom. "</b>";?> ---<?php echo $cID;?></option> </select> </td> <td style='border:0px solid gray'><br> <input type='submit' name='CreateClaim' value='<?php echo $value;?>' style='height:30px;width:80px;border:1px solid lightgray;border-radius:3px;background:<?php echo $bgColor;?>;' <?php echo $isDisable;?>> <a href='phic_claims.php?view=new&subView=new'><input type='button' name='New' value='New' style='height:30px;width:80px;border:1px solid lightgray;border-radius:3px'<?php echo $isDisableNew;?> > </td> </tr></form> <br> </table></center> </div> <div style='overflow:auto;border-radius:0px 0px 5px 5px;padding:5px;position:relative;height:397px;width:98.7%;border:1px solid #000;background:#fff;border-bottom:1px solid lightgray'> <table style='width:100%;border-collapse:collapse'> <tr> <th style='width:5%'>No.</th> <th style='width:10%'>Ref.No.</th> <th style='width:20%'Date Covered</th> <th style='width:25%'>Patient Name.</th> <th style='width:15%'>Confinement Date</th> <th style='width:10%'>Branch ID.</th> <th style='width:10%'>Encoded By</th> <th style='width:10%'> </th> </tr> <?php $tID =$_GET['id']; $getU = mysql_query("SELECT * FROM `phic_claim_summary_dtl` WHERE `hdr_id`='$tID' AND `delete`=0 ORDER by `id` ASC"); while($myMT = mysql_fetch_array($getU)){ $pID = $myMT['patient_id']; $fname=mysql_result(mysql_query("SELECT `patient_fname` FROM `patient_list` WHERE `patient_id`=$pID"),0); $lname=mysql_result(mysql_query("SELECT `patient_lname` FROM `patient_list` WHERE `patient_id`=$pID"),0); $count = $count + 1; echo "<tr>"; echo "<td>".$count."</td>"; echo "<td style='text-align:center;padding-left:0px;'>".$myMT['ref_number']."</td>"; echo "<td style='text-align:center;padding-left:0px;'>".$myMT['date_start']." - ".$myMT['date_end']."</td>"; echo "<td style='text-align:left;padding-left:10px;'>".$lname.", ".$fname."</td>"; echo "<td style='text-align:left;padding-left:10px;'>".$myMT['tx_dateA']."</td>"; echo "<td style='text-align:center;padding-left:10px;'>".$myMT['branch_id']."</td>"; echo "<td style='text-align:center;padding-left:10px;'>".$myMT['encoded_by']."</td>"; echo "<td style='text-align:center;'><a href='#'><ABBR title='This record is locked'><img src='images/istop.png' width='15px' ></img></a></ABBR></td>"; echo "<tr>"; } ?> <table> </div> </div> <?php if (isset($_GET['CreateClaim'])){ //GET CODE $startDate=$_GET['startdate']; $endDate=$_GET['enddate']; $selCom =$_GET['selCom']; $compName = explode("---",$selCom); $companyID = $compName[1]; $transID = mysql_result(mysql_query("SELECT `fv_phic_id` FROM `trans_code` WHERE `fv_phic_id`!=''"),0); $hdrsql="INSERT INTO `phic_claim_summary` (`id`, `start_date`,`end_date`,`branch_code`,`ref_number`,`date_created`,`created_by`) VALUES('','$startDate','$endDate','$companyID','$transID','$toDate','$user')"; if(!mysql_query($hdrsql)){ die('Error: ' . mysql_error()); }else{ } //UPDATE CODE $newCode = $transID + 1; mysql_query("UPDATE `trans_code` SET `fv_phic_id` = '$newCode' WHERE `fv_phic_id`!=''"); } ?>

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