File: /home/imensosw/www/imenso.co/dev/prc/pay-dash.html
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<title>Patient Portal</title>
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</head>
<body style="background: #F0F4F7;">
<!-- Payment Code pop up -->
<div class="modal fade" id="paymentCodePopup" tabindex="-1" role="dialog" aria-labelledby="exampleModalLabel" aria-hidden="true">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header">
<h5 class="modal-title" id="exampleModalLabel">Add New Payment Code</h5>
<button type="button" class="close" data-dismiss="modal" aria-label="Close"> <span aria-hidden="true">×</span>
</button>
</div>
<div class="modal-body">
<form>
<div class="form-group">
<label for="">Enter Payment Code</label>
<input type="text" class="form-control" id="" aria-describedby="emailHelp" placeholder="Payment Code e.g. 14##########">
</div>
<div class="form-group">
<label for="">Enter Last Name</label>
<input type="text" class="form-control" id="" placeholder="Last Name e.g. Smith">
</div>
</form>
</div>
<div class="modal-footer">
<button type="button" class="btn btn-login">Submit</button>
</div>
</div>
</div>
</div>
<!--/ Add new-->
<!-- Delete Confirmation -->
<div class="modal fade" id="deletePaymentCode" tabindex="-1" role="dialog" aria-labelledby="exampleModalLabel" aria-hidden="true">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header">
<h5 class="modal-title" id="exampleModalLabel">Delete</h5>
<button type="button" class="close" data-dismiss="modal" aria-label="Close"> <span aria-hidden="true">×</span>
</button>
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<div class="modal-body">Are you sure you want to delete this payment code?</div>
<div class="modal-footer">
<button type="button" class="btn btn-secondary" data-dismiss="modal">Cancel</button>
<button type="button" class="btn btn-login">Delete</button>
</div>
</div>
</div>
</div>
<div class="container-fluid">
<div id="includedContent"></div>
<div class="right right_panel animate dashboard">
<div class="m-5">
<div class="container-fluid">
<div class="row payment_code mb-5">
<div class="col-md-10 mb-3 header_area m-auto">
<div class="d-flex justify-content-between align-items-center">
<h4 calss="mb-0">Payment Plan Dashboard
<!-- <small class="subhead">Your medical billing and payment codes</small> --></h4>
<!-- <a class="btn btn btn-secondary fix_bottom" data-toggle="modal" data-target="#paymentCodePopup" href="javascript:;"><i class="fa fa-plus"></i> <span>New Payment Code</span></a> -->
</div>
</div>
<div class="col-md-10 m-auto">
<div class="infobox">
<div class="card-body">
<div class="row align-items-center">
<div class="col-sm-8">
<h2>ABC Orthopedics</h2>
<ul>
<!-- <li>Service Date(s):<strong> 1/4/2020 – 1/4/2020 </strong>
</li>
<li>Last Statement Date: <strong>2/2/2020 </strong>
</li> -->
<li class="">Payment Code: <strong>144438457067</strong>
</li>
</ul>
<!-- <a href="" class="viewbtn mt-3"> <i class="fa fa-file-pdf-o"></i>
<span>View Statement</span>
</a> -->
</div>
<div class="col-sm-4">
<div class="balance text-center mt-4">
<!-- <span class="label label-important arrowed-in">Past Due in 15 Days</span> <br><br> -->
<div>
<span class="">Balance Due:</span>
<h3>$156.23</h3>
<!-- <a class="btn btn-sm btn-primary mt-3" href="pay-bill.html">Make Payment</a> -->
<a href="pay-plan.html" class="btn btn-sm btn-login mt-3 text-uppercase font-weight-bold" href="pay-bill.html">Payment Plan</a>
</div>
</div>
</div>
</div>
<div class="details mt-5" style="display: none;">
<div class="more-details more-details_top"><a href="javascript:;" class="showmore"><span>View Details</span> <i class="fa fa-chevron-down"></i></a>
</div>
<ul class="nav nav-pills mb-5" id="pills-tab" role="tablist">
<li class="nav-item"> <a class="tab-link active" id="pills-home-tab" data-toggle="pill" href="#bDetails" role="tab" aria-controls="pills-home" aria-selected="true">Billing Details</a>
</li>
<li class="nav-item"> <a class="tab-link" id="pills-profile-tab" data-toggle="pill" href="#bSummary" role="tab" aria-controls="pills-profile" aria-selected="false">Billing Summary</a>
</li>
</ul>
<div class="tab-content" id="pills-tabContent">
<div class="tab-pane fade show active" id="bDetails" role="tabpanel" aria-labelledby="pills-home-tab">
<h5>Charges/ Credits/ Payments <i class="fa fa-question info" data-toggle="tooltip" data-placement="top" title="A description of the services rendered, along with any payments or adjustments."></i></h5>
<div class="table-responsive">
<table class="table table-bordered table-bill">
<thead>
<tr>
<th width="130">Service Date</th>
<th width="110">Invoice #</th>
<th width="250">Charge Description</th>
<th>Provider</th>
<th>Location</th>
<th width="150">Amount</th>
</tr>
</thead>
<tbody>
<tr class="highlighted">
<td>6/18/2010</td>
<td>3492719</td>
<td>Outpatient/Office consult</td>
<td>Dr. John Smith</td>
<td>Onsite Imaging Ctr</td>
<td>$290.00</td>
</tr>
<tr class="highlighted">
<td></td>
<td>3492719</td>
<td>Exam – 30 minute</td>
<td>Dr. Jim Bezamat</td>
<td>Medical Ctr East</td>
<td>$59.00</td>
</tr>
<tr class="highlighted">
<td></td>
<td>3492719</td>
<td>Xray Shoulder 2+ Views</td>
<td>Dr. John Smith</td>
<td>Onsite Imaging Ctr</td>
<td>$290.00</td>
</tr>
<tr class="highlighted">
<td></td>
<td>3492719</td>
<td>Exam – 30 minute</td>
<td>Dr. Jim Bezamat</td>
<td>Medical Ctr East</td>
<td>$59.00</td>
</tr>
<tr class="">
<td>1/4/2020</td>
<td>3497238</td>
<td>Xray Shoulder 2+ Views</td>
<td>Dr. John Smith</td>
<td>Onsite Imaging Ctr</td>
<td>$290.00</td>
</tr>
<tr class="">
<td></td>
<td>3497238</td>
<td>Exam – 30 minute</td>
<td>Dr. Jim Bezamat</td>
<td>Medical Ctr East</td>
<td>$59.00</td>
</tr>
</tbody>
</table>
</div>
<table class="table table-summary">
<tbody>
<tr>
<!-- <td width="100"></td> -->
<td>Charges/ Credits/ Payments</td>
<td width="150" class="text-right"><strong>$349.00</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Account Credit Balance <i class="fa fa-question info" data-toggle="tooltip" data-placement="top" title="A pending credit on the account. Please note that credits may be intended for specific charges that have not been transferred to patient responsibility yet."></i>
</td>
<td class="text-right"><strong> ($223.04)</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Recent Payment</td>
<td class="text-right"><strong>$5.96</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Total Amount Due</td>
<td class="text-right"><strong>$125.96</strong>
</td>
</tr>
</tbody>
</table>
<div class="text-right button-center"> <a class="btn btn-sm btn-primary mt-3" href="pay-bill.html">Make Payment</a>
</div>
</div>
<div class="tab-pane fade" id="bSummary" role="tabpanel" aria-labelledby="pills-profile-tab">
<h5>Billing Summary</h5>
<div class="table-responsive">
<table class="table table-bordered table-bill">
<thead>
<tr>
<th width="130">Service Date</th>
<th width="110">Invoice #</th>
<th>Total Charges</th>
<th>Total Credits</th>
<th>Current Balance</th>
<th>Balance Due</th>
<th>Age of DOS</th>
</tr>
</thead>
<tbody>
<tr class="">
<td>6/18/2019</td>
<td>3497238</td>
<td>$30.00</td>
<td>$19.91</td>
<td>$10.09</td>
<td>$10.09</td>
<td><span class="text-danger">Over 90 Days</span>
</td>
</tr>
<tr class="">
<td>6/18/2019</td>
<td>3492719</td>
<td>$528.00</td>
<td>$385.44</td>
<td>$142.56</td>
<td>$142.56</td>
<td>Under 90 Days</td>
</tr>
</tbody>
</table>
</div>
<table class="table table-summary">
<tbody>
<tr>
<!-- <td width="100"></td> -->
<td>Charges/ Credits/ Payments</td>
<td width="150" class="text-right"><strong>$349.00</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Account Credit Balance <i class="fa fa-question info" data-toggle="tooltip" data-placement="top" title="A pending credit on the account. Please note that credits may be intended for specific charges that have not been transferred to patient responsibility yet."></i>
</td>
<td class="text-right"><strong> ($223.04)</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Recent Payment</td>
<td class="text-right"><strong>$10.96</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Total Amount Due</td>
<td class="text-right"><strong>$125.96</strong>
</td>
</tr>
</tbody>
</table>
<div class="text-right button-center"> <a class="btn btn-sm btn-primary mt-3" href="pay-bill.html">Make Payment</a>
</div>
</div>
</div>
</div>
</div>
<!-- <div class="more-details"><a href="javascript:;" class="showmore"><span>View Details</span> <i class="fa fa-chevron-down"></i></a>
</div> -->
</div>
</div>
<div class="col-md-10 mb-4 m-auto">
<div class="infobox">
<div class="card-body">
<div class="row align-items-center">
<div class="col-sm-8">
<h2>ABC</h2>
<ul>
<!-- <li>Service Date(s):<strong> 1/4/2020 – 1/4/2020 </strong>
</li>
<li>Last Statement Date: <strong>2/2/2020 </strong>
</li> -->
<li class="">Payment Code: <strong>144438457068</strong>
</li>
</ul>
<!-- <a href="" class="viewbtn mt-3"> <i class="fa fa-file-pdf-o"></i>
<span>View Statement</span>
</a> -->
</div>
<div class="col-sm-4">
<div class="balance text-center mt-4">
<!-- <span class="label label-important arrowed-in">Past Due in 15 Days</span> <br><br> -->
<div>
<span class="">Balance Due:</span>
<h3>$156.23</h3>
<!-- <a class="btn btn-sm btn-primary mt-3" href="pay-bill.html">Make Payment</a> -->
<a href="pay-plan.html" class="btn btn-sm btn-login mt-3 text-uppercase font-weight-bold" href="pay-bill.html">Payment Plan</a>
</div>
</div>
</div>
</div>
<div class="details mt-5" style="display: none;">
<div class="more-details more-details_top"><a href="javascript:;" class="showmore"><span>View Details</span> <i class="fa fa-chevron-down"></i></a>
</div>
<ul class="nav nav-pills mb-5" id="pills-tab" role="tablist">
<li class="nav-item"> <a class="tab-link active" id="pills-home-tab" data-toggle="pill" href="#bDetails" role="tab" aria-controls="pills-home" aria-selected="true">Billing Details</a>
</li>
<li class="nav-item"> <a class="tab-link" id="pills-profile-tab" data-toggle="pill" href="#bSummary" role="tab" aria-controls="pills-profile" aria-selected="false">Billing Summary</a>
</li>
</ul>
<div class="tab-content" id="pills-tabContent">
<div class="tab-pane fade show active" id="bDetails" role="tabpanel" aria-labelledby="pills-home-tab">
<h5>Charges/ Credits/ Payments <i class="fa fa-question info" data-toggle="tooltip" data-placement="top" title="A description of the services rendered, along with any payments or adjustments."></i></h5>
<div class="table-responsive">
<table class="table table-bordered table-bill">
<thead>
<tr>
<th width="130">Service Date</th>
<th width="110">Invoice #</th>
<th width="250">Charge Description</th>
<th>Provider</th>
<th>Location</th>
<th width="150">Amount</th>
</tr>
</thead>
<tbody>
<tr class="highlighted">
<td>6/18/2010</td>
<td>3492719</td>
<td>Outpatient/Office consult</td>
<td>Dr. John Smith</td>
<td>Onsite Imaging Ctr</td>
<td>$290.00</td>
</tr>
<tr class="highlighted">
<td></td>
<td>3492719</td>
<td>Exam – 30 minute</td>
<td>Dr. Jim Bezamat</td>
<td>Medical Ctr East</td>
<td>$59.00</td>
</tr>
<tr class="highlighted">
<td></td>
<td>3492719</td>
<td>Xray Shoulder 2+ Views</td>
<td>Dr. John Smith</td>
<td>Onsite Imaging Ctr</td>
<td>$290.00</td>
</tr>
<tr class="highlighted">
<td></td>
<td>3492719</td>
<td>Exam – 30 minute</td>
<td>Dr. Jim Bezamat</td>
<td>Medical Ctr East</td>
<td>$59.00</td>
</tr>
<tr class="">
<td>1/4/2020</td>
<td>3497238</td>
<td>Xray Shoulder 2+ Views</td>
<td>Dr. John Smith</td>
<td>Onsite Imaging Ctr</td>
<td>$290.00</td>
</tr>
<tr class="">
<td></td>
<td>3497238</td>
<td>Exam – 30 minute</td>
<td>Dr. Jim Bezamat</td>
<td>Medical Ctr East</td>
<td>$59.00</td>
</tr>
</tbody>
</table>
</div>
<table class="table table-summary">
<tbody>
<tr>
<!-- <td width="100"></td> -->
<td>Charges/ Credits/ Payments</td>
<td width="150" class="text-right"><strong>$349.00</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Account Credit Balance <i class="fa fa-question info" data-toggle="tooltip" data-placement="top" title="A pending credit on the account. Please note that credits may be intended for specific charges that have not been transferred to patient responsibility yet."></i>
</td>
<td class="text-right"><strong> ($223.04)</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Recent Payment</td>
<td class="text-right"><strong>$5.96</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Total Amount Due</td>
<td class="text-right"><strong>$125.96</strong>
</td>
</tr>
</tbody>
</table>
<div class="text-right button-center"> <a class="btn btn-sm btn-primary mt-3" href="pay-bill.html">Make Payment</a>
</div>
</div>
<div class="tab-pane fade" id="bSummary" role="tabpanel" aria-labelledby="pills-profile-tab">
<h5>Billing Summary</h5>
<div class="table-responsive">
<table class="table table-bordered table-bill">
<thead>
<tr>
<th width="130">Service Date</th>
<th width="110">Invoice #</th>
<th>Total Charges</th>
<th>Total Credits</th>
<th>Current Balance</th>
<th>Balance Due</th>
<th>Age of DOS</th>
</tr>
</thead>
<tbody>
<tr class="">
<td>6/18/2019</td>
<td>3497238</td>
<td>$30.00</td>
<td>$19.91</td>
<td>$10.09</td>
<td>$10.09</td>
<td><span class="text-danger">Over 90 Days</span>
</td>
</tr>
<tr class="">
<td>6/18/2019</td>
<td>3492719</td>
<td>$528.00</td>
<td>$385.44</td>
<td>$142.56</td>
<td>$142.56</td>
<td>Under 90 Days</td>
</tr>
</tbody>
</table>
</div>
<table class="table table-summary">
<tbody>
<tr>
<!-- <td width="100"></td> -->
<td>Charges/ Credits/ Payments</td>
<td width="150" class="text-right"><strong>$349.00</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Account Credit Balance <i class="fa fa-question info" data-toggle="tooltip" data-placement="top" title="A pending credit on the account. Please note that credits may be intended for specific charges that have not been transferred to patient responsibility yet."></i>
</td>
<td class="text-right"><strong> ($223.04)</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Recent Payment</td>
<td class="text-right"><strong>$10.96</strong>
</td>
</tr>
<tr>
<!-- <td></td> -->
<td>Total Amount Due</td>
<td class="text-right"><strong>$125.96</strong>
</td>
</tr>
</tbody>
</table>
<div class="text-right button-center"> <a class="btn btn-sm btn-primary mt-3" href="pay-bill.html">Make Payment</a>
</div>
</div>
</div>
</div>
</div>
<!-- <div class="more-details"><a href="javascript:;" class="showmore"><span>View Details</span> <i class="fa fa-chevron-down"></i></a>
</div> -->
</div>
</div>
</div>
</div>
<!--/ Details-->
</div>
</div>
</div>
</div>
</div>
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$(document).ready(function(){
$('.showmore').click(function(){
$('.details').slideToggle('slow');
$('.showmore i').toggleClass("fa-chevron-down fa-chevron-up");
/*if($(this).text() == 'Hide Details') {
$(this).text('View Details');
}
else {
$(this).text('Hide Details');
}*/
var txt= $('.showmore').find('span');
//alert(txt);
if(txt.html() == 'View Details') {
// alert("find");
$(txt).html('Hide Details');
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