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42 lines
1.3 KiB
42 lines
1.3 KiB
2 years ago
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{% extends "patient/card/card_base.html.twig" %}
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{% block content %}
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<div class="container">
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<div class="row">
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<div class="col-4">{{ "Patient Balance Due"|xlt }}</div>
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<div class="col">{{ patientBalance|money|text }}</div>
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</div>
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<div class="row">
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<div class="col-4">{{ "Insurance Balance Due"|xlt }}</div>
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<div class="col">{{ insuranceBalance|money|text }}</div>
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</div>
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<div class="row">
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<div class="col-4 font-weight-bold">{{ "Total Balance Due"|xlt }}</div>
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<div class="col font-weight-bold">{{ totalBalance|money|text }}</div>
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</div>
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{% if billingNote %}
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<div class="row">
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<div class="col-4">{{ "Billing Note"|xlt }}</div>
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<div class="col">{{ billingNote|text }}</div>
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</div>
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{% endif %}
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{% if provider %}
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<div class="row">
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<div class="col-4">{{ "Primary Insurance"|xlt }}</div>
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<div class="col">{{ insName|text }}</div>
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</div>
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{% if copay %}
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<div class="row">
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<div class="col-4">{{ "Copay"|xlt }}</div>
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<div class="col">{{ copay|text }}</div>
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</div>
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{% endif %}
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<div class="row">
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<div class="col-4">{{ "Effective Date"|xlt }}</div>
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<div class="col">{{ effDate|shortDate|text }}</div>
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</div>
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{% endif %}
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</div>
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{% endblock %}
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