/// <summary>
/// Implementation of mapping as described at http://ahca.myflorida.com/Medicaid/meds/pdf/837i_v2-1_crosswalk_v2.pdf
/// Detailed instructions found at https://www.cms.gov/transmittals/downloads/R1104CP.pdf
/// </summary>
/// <param name="claim"></param>
/// <returns></returns>
public virtual UB04Claim TransformClaimToUB04(Claim claim)
{
var ub = new UB04Claim();
Provider provider = claim.BillingProvider;
ub.Field01_BillingProvider.Line1 = provider.Name.ToString();
ub.Field01_BillingProvider.Line2 = provider.Address.Line1;
if (string.IsNullOrWhiteSpace(provider.Address.Line2))
ub.Field01_BillingProvider.Line3 = provider.Address.Locale;
else
{
ub.Field01_BillingProvider.Line3 = provider.Address.Line2;
ub.Field01_BillingProvider.Line4 = provider.Address.Locale;
}
provider = claim.PayToProvider;
ub.Field02_PayToProvider.Line1 = provider.Name.ToString();
ub.Field02_PayToProvider.Line2 = provider.Address.Line1;
if (string.IsNullOrWhiteSpace(provider.Address.Line2))
ub.Field02_PayToProvider.Line3 = provider.Address.Locale;
else
{
ub.Field02_PayToProvider.Line3 = provider.Address.Line2;
ub.Field02_PayToProvider.Line4 = provider.Address.Locale;
}
ub.Field03a_PatientControlNumber = claim.PatientControlNumber;
ub.Field03b_MedicalRecordNumber = claim.MedicalRecordNumber;
ub.Field04_TypeOfBill = claim.BillTypeCode;
ub.Field05_FederalTaxId = claim.PayToProvider.TaxId;
ub.Field06_StatementCoversPeriod.FromDate = String.Format("{0:MMddyy}", claim.StatementFromDate);
ub.Field06_StatementCoversPeriod.ThroughDate = String.Format("{0:MMddyy}", claim.StatementToDate);
ClaimMember patient = claim.Patient ?? claim.Subscriber;
ub.Field08_PatientName_a = patient.Name.Identification.Id;
ub.Field08_PatientName_b = patient.Name.ToString();
ub.Field09_PatientAddress.a_Street = patient.Address.Line1;
ub.Field09_PatientAddress.b_City = patient.Address.City;
ub.Field09_PatientAddress.c_State = patient.Address.StateCode;
ub.Field09_PatientAddress.d_PostalCode = patient.Address.PostalCode;
ub.Field09_PatientAddress.e_CountryCode = patient.Address.CountryCode;
ub.Field10_Birthdate = String.Format("{0:MMddyyyy}", patient.DateOfBirth);
ub.Field11_Sex = patient.Gender.ToString().Substring(0, 1);
ub.Field12_AdmissionDate = String.Format("{0:MMddyy}", claim.AdmissionDate);
ub.Field13_AdmissionHour = String.Format("{0:HH}", claim.AdmissionDate);
ub.Field14_AdmissionType = claim.AdmissionType.Code;
ub.Field15_AdmissionSource = claim.AdmissionSource.Code;
ub.Field16_DischargeHour = String.Format("{0:HH}", claim.DischargeTime);
ub.Field17_DischargeStatus = claim.PatientStatus.Code;
if (claim.Conditions.Count > 0) ub.Field18_ConditionCode01 = claim.Conditions[0].Code;
if (claim.Conditions.Count > 1) ub.Field19_ConditionCode02 = claim.Conditions[1].Code;
if (claim.Conditions.Count > 2) ub.Field20_ConditionCode03 = claim.Conditions[2].Code;
if (claim.Conditions.Count > 3) ub.Field21_ConditionCode04 = claim.Conditions[3].Code;
if (claim.Conditions.Count > 4) ub.Field22_ConditionCode05 = claim.Conditions[4].Code;
if (claim.Conditions.Count > 5) ub.Field23_ConditionCode06 = claim.Conditions[5].Code;
if (claim.Conditions.Count > 6) ub.Field24_ConditionCode07 = claim.Conditions[6].Code;
if (claim.Conditions.Count > 7) ub.Field25_ConditionCode08 = claim.Conditions[7].Code;
if (claim.Conditions.Count > 8) ub.Field26_ConditionCode09 = claim.Conditions[8].Code;
if (claim.Conditions.Count > 9) ub.Field27_ConditionCode10 = claim.Conditions[9].Code;
if (claim.Conditions.Count > 10) ub.Field28_ConditionCode11 = claim.Conditions[1].Code;
ub.Field29_AccidentState = ""; // field ignored by CMS
if (claim.Occurrences.Count > 0) ub.Field31a_Occurrence.CopyFrom(claim.Occurrences[0]);
if (claim.Occurrences.Count > 1) ub.Field31b_Occurrence.CopyFrom(claim.Occurrences[1]);
if (claim.Occurrences.Count > 2) ub.Field32a_Occurrence.CopyFrom(claim.Occurrences[2]);
if (claim.Occurrences.Count > 3) ub.Field32b_Occurrence.CopyFrom(claim.Occurrences[3]);
if (claim.Occurrences.Count > 4) ub.Field33a_Occurrence.CopyFrom(claim.Occurrences[4]);
if (claim.Occurrences.Count > 5) ub.Field33b_Occurrence.CopyFrom(claim.Occurrences[5]);
if (claim.Occurrences.Count > 6) ub.Field34a_Occurrence.CopyFrom(claim.Occurrences[6]);
if (claim.Occurrences.Count > 7) ub.Field34b_Occurrence.CopyFrom(claim.Occurrences[7]);
List<UB04OccurrenceSpan> spans = new List<UB04OccurrenceSpan>();
if (claim.Occurrences.Count > 8) spans.Add(new UB04OccurrenceSpan().CopyFrom(claim.Occurrences[8]));
if (claim.Occurrences.Count > 9) spans.Add(new UB04OccurrenceSpan().CopyFrom(claim.Occurrences[9]));
foreach (CodedDateRange span in claim.OccurrenceSpans)
spans.Add(new UB04OccurrenceSpan().CopyFrom(span));
if (spans.Count > 0) ub.Field35a_OccurrenceSpan = spans[0];
if (spans.Count > 1) ub.Field35b_OccurrenceSpan = spans[1];
if (spans.Count > 2) ub.Field36a_OccurrenceSpan = spans[2];
if (spans.Count > 3) ub.Field36b_OccurrenceSpan = spans[3];
List<string> blockLines = new List<string>();
blockLines.Add(claim.Subscriber.Name.ToString());
ub.Field38_ResponsibleParty.Line1 = blockLines[0];
if (claim.Subscriber.Address != null)
{
blockLines.Add(claim.Subscriber.Address.Line1);
if (!string.IsNullOrWhiteSpace(claim.Subscriber.Address.Line2))
blockLines.Add(claim.Subscriber.Address.Line2);
blockLines.Add(claim.Subscriber.Address.Locale);
ub.Field38_ResponsibleParty.Line2 = blockLines[1];
ub.Field38_ResponsibleParty.Line3 = blockLines[2];
}
if (blockLines.Count > 3)
ub.Field38_ResponsibleParty.Line4 = blockLines[3];
if (claim.Values.Count > 0) ub.Field39a_Value.CopyFrom(claim.Values[0]);
if (claim.Values.Count > 1) ub.Field39b_Value.CopyFrom(claim.Values[1]);
if (claim.Values.Count > 2) ub.Field39c_Value.CopyFrom(claim.Values[2]);
if (claim.Values.Count > 3) ub.Field39d_Value.CopyFrom(claim.Values[3]);
if (claim.Values.Count > 4) ub.Field40a_Value.CopyFrom(claim.Values[4]);
if (claim.Values.Count > 5) ub.Field40b_Value.CopyFrom(claim.Values[5]);
if (claim.Values.Count > 6) ub.Field40c_Value.CopyFrom(claim.Values[6]);
if (claim.Values.Count > 7) ub.Field40d_Value.CopyFrom(claim.Values[7]);
if (claim.Values.Count > 8) ub.Field41a_Value.CopyFrom(claim.Values[8]);
if (claim.Values.Count > 9) ub.Field41b_Value.CopyFrom(claim.Values[9]);
if (claim.Values.Count > 10) ub.Field41c_Value.CopyFrom(claim.Values[10]);
if (claim.Values.Count > 11) ub.Field41d_Value.CopyFrom(claim.Values[11]);
foreach (var line in claim.ServiceLines)
{
ub.ServiceLines.Add(new UB04ServiceLine {
Field42_RevenueCode = line.RevenueCode,
Field44_ProcedureCodes = line.Procedure.ProcedureCode,
Field45_ServiceDate = String.Format("{0:MMddyy}", line.ServiceDateFrom),
Field46_ServiceUnits = line.Quantity.ToString(),
Field47_TotalCharges = line.ChargeAmount,
Field48_NonCoveredCharges = line.NonCoveredChargeAmount
});
}
ub.Field47_Line23_TotalCharges = claim.TotalClaimChargeAmount;
ub.Field48_Line23_NonCoveredCharges = claim.ServiceLines.Sum(sl => sl.NonCoveredChargeAmount);
ub.Field56_NationalProviderIdentifier = claim.BillingProvider.Npi;
if (claim.BillingProvider.Identifications.Count >= 1)
ub.Field57_OtherProviderIdA = claim.BillingProvider.Identifications[0].Id;
if (claim.BillingProvider.Identifications.Count >= 2)
ub.Field57_OtherProviderIdB = claim.BillingProvider.Identifications[1].Id;
if (claim.BillingProvider.Identifications.Count >= 3)
ub.Field57_OtherProviderIdC = claim.BillingProvider.Identifications[2].Id;
if (claim.Payer != null)
{
ub.PayerA_Primary.Field50_PayerName = claim.Payer.Name.Formatted();
ub.PayerA_Primary.Field51_HealthPlanId = claim.Payer.Name.Identification.Id;
}
ub.PayerA_Primary.Field52_ReleaseOfInfoCertIndicator = claim.ReleaseOfInformationCode;
ub.PayerA_Primary.Field53_AssignmentOfBenefitsCertIndicator = claim.BenefitsAssignmentCertificationIndicator;
ub.PayerA_Primary.Field58_InsuredsName = claim.Subscriber.Name.Formatted();
ub.PayerA_Primary.Field59_PatientRelationship = claim.SubscriberInformation.IndividualRelationshipCode;
ub.PayerA_Primary.Field60_InsuredsUniqueId = claim.Subscriber.MemberId;
ub.PayerA_Primary.Field61_GroupName = claim.SubscriberInformation.Name;
ub.PayerA_Primary.Field62_InsuredsGroupNumber = claim.SubscriberInformation.ReferenceIdentification;
if (claim.OtherSubscriberInformations.Count > 0)
{
var secondarySubscriber = claim.OtherSubscriberInformations[0];
if (secondarySubscriber.OtherPayer != null)
{
ub.PayerB_Secondary.Field50_PayerName = secondarySubscriber.OtherPayer.Formatted();
ub.PayerB_Secondary.Field51_HealthPlanId = secondarySubscriber.OtherPayer.Identification.Id;
}
ub.PayerB_Secondary.Field52_ReleaseOfInfoCertIndicator = secondarySubscriber.ReleaseOfInformationCode;
ub.PayerB_Secondary.Field53_AssignmentOfBenefitsCertIndicator = secondarySubscriber.BenefitsAssignmentCertificationIndicator;
ub.PayerB_Secondary.Field54_PriorPayments = secondarySubscriber.PayorPaidAmount;
ub.PayerB_Secondary.Field55_EstimatedAmountDue = secondarySubscriber.RemainingPatientLiability;
ub.PayerB_Secondary.Field58_InsuredsName = secondarySubscriber.Name.Formatted();
ub.PayerB_Secondary.Field59_PatientRelationship = secondarySubscriber.SubscriberInformation.IndividualRelationshipCode;
ub.PayerB_Secondary.Field60_InsuredsUniqueId = secondarySubscriber.Name.Identification.Id;
ub.PayerB_Secondary.Field61_GroupName = secondarySubscriber.SubscriberInformation.Name;
ub.PayerB_Secondary.Field62_InsuredsGroupNumber = secondarySubscriber.SubscriberInformation.ReferenceIdentification;
}
if (claim.OtherSubscriberInformations.Count > 1)
{
var TertiarySubscriber = claim.OtherSubscriberInformations[1];
if (TertiarySubscriber.OtherPayer != null)
{
ub.PayerC_Tertiary.Field50_PayerName = TertiarySubscriber.OtherPayer.Formatted();
ub.PayerC_Tertiary.Field51_HealthPlanId = TertiarySubscriber.OtherPayer.Identification.Id;
}
ub.PayerC_Tertiary.Field52_ReleaseOfInfoCertIndicator = TertiarySubscriber.ReleaseOfInformationCode;
ub.PayerC_Tertiary.Field53_AssignmentOfBenefitsCertIndicator = TertiarySubscriber.BenefitsAssignmentCertificationIndicator;
ub.PayerC_Tertiary.Field54_PriorPayments = TertiarySubscriber.PayorPaidAmount;
ub.PayerC_Tertiary.Field55_EstimatedAmountDue = TertiarySubscriber.RemainingPatientLiability;
ub.PayerC_Tertiary.Field58_InsuredsName = TertiarySubscriber.Name.Formatted();
ub.PayerC_Tertiary.Field59_PatientRelationship = TertiarySubscriber.SubscriberInformation.IndividualRelationshipCode;
ub.PayerC_Tertiary.Field60_InsuredsUniqueId = TertiarySubscriber.Name.Identification.Id;
ub.PayerC_Tertiary.Field61_GroupName = TertiarySubscriber.SubscriberInformation.Name;
ub.PayerC_Tertiary.Field62_InsuredsGroupNumber = TertiarySubscriber.SubscriberInformation.ReferenceIdentification;
}
ub.Field63A_TreatmentAuthorizationCode = claim.PriorAuthorizationNumber;
var controlNumbers = claim.Identifications.Where(id => (new string[] {"F8","D9","9A","9C","LX"}).Contains(id.Qualifier)).ToList();
if (controlNumbers.Count > 0)
ub.Field64A_DocumentControlNumber = string.Format("{0}: {1}", controlNumbers[0].Qualifier, controlNumbers[0].Id);
if (controlNumbers.Count > 1)
ub.Field64B_DocumentControlNumber = string.Format("{0}: {1}", controlNumbers[1].Qualifier, controlNumbers[1].Id);
if (controlNumbers.Count > 2)
ub.Field64C_DocumentControlNumber = string.Format("{0}: {1}", controlNumbers[2].Qualifier, controlNumbers[2].Id);
if (claim.Diagnoses.FirstOrDefault(d => d.Version == CodeListEnum.ICD9) != null)
ub.Field66_Version = "9";
var principalDiagnosis = claim.Diagnoses.FirstOrDefault(d => d.DiagnosisType == DiagnosisTypeEnum.Principal);
if (principalDiagnosis != null)
ub.Field67_PrincipleDiagnosis.CopyFrom(principalDiagnosis);
var otherDiagnoses = claim.Diagnoses.Where(d => d.DiagnosisType == DiagnosisTypeEnum.Other).ToList();
if (otherDiagnoses.Count > 0) ub.Field67A_Diagnosis.CopyFrom(otherDiagnoses[0]);
if (otherDiagnoses.Count > 1) ub.Field67B_Diagnosis.CopyFrom(otherDiagnoses[1]);
if (otherDiagnoses.Count > 2) ub.Field67C_Diagnosis.CopyFrom(otherDiagnoses[2]);
if (otherDiagnoses.Count > 3) ub.Field67D_Diagnosis.CopyFrom(otherDiagnoses[3]);
if (otherDiagnoses.Count > 4) ub.Field67E_Diagnosis.CopyFrom(otherDiagnoses[4]);
if (otherDiagnoses.Count > 5) ub.Field67F_Diagnosis.CopyFrom(otherDiagnoses[5]);
if (otherDiagnoses.Count > 6) ub.Field67G_Diagnosis.CopyFrom(otherDiagnoses[6]);
if (otherDiagnoses.Count > 7) ub.Field67H_Diagnosis.CopyFrom(otherDiagnoses[7]);
if (otherDiagnoses.Count > 8) ub.Field67I_Diagnosis.CopyFrom(otherDiagnoses[8]);
if (otherDiagnoses.Count > 9) ub.Field67J_Diagnosis.CopyFrom(otherDiagnoses[9]);
if (otherDiagnoses.Count > 10) ub.Field67K_Diagnosis.CopyFrom(otherDiagnoses[10]);
if (otherDiagnoses.Count > 11) ub.Field67L_Diagnosis.CopyFrom(otherDiagnoses[11]);
if (otherDiagnoses.Count > 12) ub.Field67M_Diagnosis.CopyFrom(otherDiagnoses[12]);
if (otherDiagnoses.Count > 13) ub.Field67N_Diagnosis.CopyFrom(otherDiagnoses[13]);
if (otherDiagnoses.Count > 14) ub.Field67O_Diagnosis.CopyFrom(otherDiagnoses[14]);
if (otherDiagnoses.Count > 15) ub.Field67P_Diagnosis.CopyFrom(otherDiagnoses[15]);
if (otherDiagnoses.Count > 16) ub.Field67Q_Diagnosis.CopyFrom(otherDiagnoses[16]);
var admittingDiagnosis = claim.Diagnoses.FirstOrDefault(d => d.DiagnosisType == DiagnosisTypeEnum.Admitting);
if (admittingDiagnosis != null)
ub.Field69_AdmittingDiagnosisCode.CopyFrom(admittingDiagnosis);
var patientReasonDiagnoses = claim.Diagnoses.Where(d => d.DiagnosisType == DiagnosisTypeEnum.PatientReason).ToList();
if (patientReasonDiagnoses.Count > 0) ub.Field70a_PatientReasonDiagnosisCode.CopyFrom(patientReasonDiagnoses[0]);
if (patientReasonDiagnoses.Count > 1) ub.Field70b_PatientReasonDiagnosisCode.CopyFrom(patientReasonDiagnoses[1]);
if (patientReasonDiagnoses.Count > 2) ub.Field70c_PatientReasonDiagnosisCode.CopyFrom(patientReasonDiagnoses[2]);
if (claim.DiagnosisRelatedGroup != null)
ub.Field71_PPSCode = claim.DiagnosisRelatedGroup.Code;
var causes = claim.Diagnoses.Where(d => d.DiagnosisType == DiagnosisTypeEnum.ExternalCauseOfInjury).ToList();
if (causes.Count > 0) ub.Field72a_ExternalCauseOfInjury.CopyFrom(causes[0]);
if (causes.Count > 1) ub.Field72b_ExternalCauseOfInjury.CopyFrom(causes[1]);
if (causes.Count > 2) ub.Field72c_ExternalCauseOfInjury.CopyFrom(causes[2]);
var principalProcedure = claim.Procedures.FirstOrDefault(p => p.IsPrincipal);
if (principalProcedure != null)
ub.Field74_PrincipalProcedure.CopyFrom(principalProcedure);
var otherProcedures = claim.Procedures.Where(p => !p.IsPrincipal).ToList();
if (otherProcedures.Count > 0) ub.Field74a_OtherProcedure.CopyFrom(otherProcedures[0]);
if (otherProcedures.Count > 1) ub.Field74b_OtherProcedure.CopyFrom(otherProcedures[1]);
if (otherProcedures.Count > 2) ub.Field74c_OtherProcedure.CopyFrom(otherProcedures[2]);
if (otherProcedures.Count > 3) ub.Field74d_OtherProcedure.CopyFrom(otherProcedures[3]);
if (otherProcedures.Count > 4) ub.Field74e_OtherProcedure.CopyFrom(otherProcedures[4]);
if (claim.AttendingProvider != null)
{
ub.Field76_AttendingPhysician.Npi = claim.AttendingProvider.Npi;
ub.Field76_AttendingPhysician.LastName = claim.AttendingProvider.Name.LastName;
ub.Field76_AttendingPhysician.FirstName = claim.AttendingProvider.Name.FirstName;
var id = claim.AttendingProvider.Identifications.FirstOrDefault();
if (id != null)
{
ub.Field76_AttendingPhysician.IdentifierQualifier = id.Qualifier;
ub.Field76_AttendingPhysician.Identifier = id.Id;
}
}
if (claim.OperatingPhysician != null)
{
ub.Field77_OperatingPhysician.Npi = claim.OperatingPhysician.Npi;
ub.Field77_OperatingPhysician.LastName = claim.OperatingPhysician.Name.LastName;
ub.Field77_OperatingPhysician.FirstName = claim.OperatingPhysician.Name.FirstName;
var id = claim.OperatingPhysician.Identifications.FirstOrDefault();
if (id != null)
{
ub.Field77_OperatingPhysician.IdentifierQualifier = id.Qualifier;
ub.Field77_OperatingPhysician.Identifier = id.Id;
}
}
if (claim.OtherOperatingPhysician != null)
{
ub.Field78_OtherProvider.Npi = claim.OtherOperatingPhysician.Npi;
ub.Field78_OtherProvider.LastName = claim.OtherOperatingPhysician.Name.LastName;
ub.Field78_OtherProvider.FirstName = claim.OtherOperatingPhysician.Name.FirstName;
var id = claim.OtherOperatingPhysician.Identifications.FirstOrDefault();
if (id != null)
{
ub.Field78_OtherProvider.IdentifierQualifier = id.Qualifier;
ub.Field78_OtherProvider.Identifier = id.Id;
}
}
return ub;
}
public virtual List<FormPage> TransformUB04ToFormPages(UB04Claim ub04)
{
List<FormPage> pages = new List<FormPage>();
int pageCount = 1 + ((ub04.ServiceLines.Count - 1) / 22);
FormPage page = null;
for (int i = 0; i < ub04.ServiceLines.Count; i++)
{
if (i % 22 == 0)
{
page = new FormPage();
pages.Add(page);
page.MasterReference = "ub04";
page.ImagePath = _formImagePath;
// header
// Box 1
AddBlock(page, 2, 1, 28, ub04.Field01_BillingProvider.Line1);
AddBlock(page, 2, 2, 28, ub04.Field01_BillingProvider.Line2);
AddBlock(page, 2, 3, 28, ub04.Field01_BillingProvider.Line3);
AddBlock(page, 2, 4, 28, ub04.Field01_BillingProvider.Line4);
// Box 2
AddBlock(page, 32, 1, 28, ub04.Field02_PayToProvider.Line1);
AddBlock(page, 32, 2, 28, ub04.Field02_PayToProvider.Line2);
AddBlock(page, 32, 3, 28, ub04.Field02_PayToProvider.Line3);
AddBlock(page, 32, 4, 28, ub04.Field02_PayToProvider.Line4);
// Box 3
AddBlock(page, 65, 1, 27, ub04.Field03a_PatientControlNumber);
AddBlock(page, 65, 2, 27, ub04.Field03b_MedicalRecordNumber);
// Box 4
AddBlock(page, 94, 2, 5, ub04.Field04_TypeOfBill);
// Box 5
AddBlock(page, 62, 4, 10, ub04.Field05_FederalTaxId);
// Box 6 - Statement Covers Period
AddBlock(page, 74, 4, 9, ub04.Field06_StatementCoversPeriod.FromDate);
AddBlock(page, 82, 4, 9, ub04.Field06_StatementCoversPeriod.ThroughDate);
// Box 7 - Blank
AddBlock(page, 91, 3, 8, ub04.Field07.Line1);
AddBlock(page, 91, 4, 8, ub04.Field07.Line2);
// Box 8
AddBlock(page, 15, 5, 21, ub04.Field08_PatientName_a);
AddBlock(page, 3, 6, 33, ub04.Field08_PatientName_b);
// Box 9
AddBlock(page, 51, 5, 48, ub04.Field09_PatientAddress.a_Street);
AddBlock(page, 39, 6, 37, ub04.Field09_PatientAddress.b_City);
AddBlock(page, 78, 6, 2, ub04.Field09_PatientAddress.c_State);
AddBlock(page, 83, 6, 10, ub04.Field09_PatientAddress.d_PostalCode);
AddBlock(page, 96, 6, 3, ub04.Field09_PatientAddress.e_CountryCode);
// Box 10
AddBlock(page, 2, 8, 8, ub04.Field10_Birthdate);
// Box 11
AddBlock(page, 13, 8, 1, ub04.Field11_Sex);
// Box 12-15
AddBlock(page, 16, 8, 6, ub04.Field12_AdmissionDate);
AddBlock(page, 23, 8, 2, ub04.Field13_AdmissionHour);
AddBlock(page, 27, 8, 2, ub04.Field14_AdmissionType);
AddBlock(page, 30, 8, 2, ub04.Field15_AdmissionSource);
// Box 16
AddBlock(page, 34, 8, 2, ub04.Field16_DischargeHour);
// Box 17
AddBlock(page, 38, 8, 2, ub04.Field17_DischargeStatus);
// Box 18 - 28 Condition Codes
AddBlock(page, 41, 8, 2, ub04.Field18_ConditionCode01);
AddBlock(page, 45, 8, 2, ub04.Field19_ConditionCode02);
AddBlock(page, 48, 8, 2, ub04.Field20_ConditionCode03);
AddBlock(page, 52, 8, 2, ub04.Field21_ConditionCode04);
AddBlock(page, 56, 8, 2, ub04.Field22_ConditionCode05);
AddBlock(page, 59, 8, 2, ub04.Field23_ConditionCode06);
AddBlock(page, 63, 8, 2, ub04.Field24_ConditionCode07);
AddBlock(page, 66, 8, 2, ub04.Field25_ConditionCode08);
AddBlock(page, 70, 8, 2, ub04.Field26_ConditionCode09);
AddBlock(page, 73.5m, 8, 2, ub04.Field27_ConditionCode10);
AddBlock(page, 77, 8, 2, ub04.Field28_ConditionCode11);
// Box 29
AddBlock(page, 81, 8, 2, ub04.Field29_AccidentState);
// Box 30
AddBlock(page, 85, 8, 14, ub04.Field30);
// Box 31
AddBlock(page, 2, 10, 2, ub04.Field31a_Occurrence.Code);
AddBlock(page, 6, 10, 6, ub04.Field31a_Occurrence.Date);
AddBlock(page, 2, 11, 2, ub04.Field31b_Occurrence.Code);
AddBlock(page, 6, 11, 6, ub04.Field31b_Occurrence.Date);
// Box 32
AddBlock(page, 14, 10, 2, ub04.Field32a_Occurrence.Code);
AddBlock(page, 18, 10, 6, ub04.Field32a_Occurrence.Date);
AddBlock(page, 14, 11, 2, ub04.Field32b_Occurrence.Code);
AddBlock(page, 18, 11, 6, ub04.Field32b_Occurrence.Date);
// Box 33
AddBlock(page, 26, 10, 2, ub04.Field33a_Occurrence.Code);
AddBlock(page, 30, 10, 6, ub04.Field33a_Occurrence.Date);
AddBlock(page, 26, 11, 2, ub04.Field33b_Occurrence.Code);
AddBlock(page, 30, 11, 6, ub04.Field33b_Occurrence.Date);
// Box 34
AddBlock(page, 38, 10, 2, ub04.Field34a_Occurrence.Code);
AddBlock(page, 41, 10, 6, ub04.Field34a_Occurrence.Date);
AddBlock(page, 38, 11, 2, ub04.Field34b_Occurrence.Code);
AddBlock(page, 41, 11, 6, ub04.Field34b_Occurrence.Date);
// Box 35
AddBlock(page, 50, 10, 2, ub04.Field35a_OccurrenceSpan.Code);
AddBlock(page, 53, 10, 6, ub04.Field35a_OccurrenceSpan.FromDate);
AddBlock(page, 62, 10, 6, ub04.Field35a_OccurrenceSpan.ThroughDate);
AddBlock(page, 50, 11, 2, ub04.Field35b_OccurrenceSpan.Code);
AddBlock(page, 53, 11, 6, ub04.Field35b_OccurrenceSpan.FromDate);
AddBlock(page, 62, 11, 6, ub04.Field35b_OccurrenceSpan.ThroughDate);
// Box 36
AddBlock(page, 70, 10, 2, ub04.Field36a_OccurrenceSpan.Code);
AddBlock(page, 74, 10, 6, ub04.Field36a_OccurrenceSpan.FromDate);
AddBlock(page, 82, 10, 6, ub04.Field36a_OccurrenceSpan.ThroughDate);
AddBlock(page, 70, 11, 2, ub04.Field36b_OccurrenceSpan.Code);
AddBlock(page, 74, 11, 6, ub04.Field36b_OccurrenceSpan.FromDate);
AddBlock(page, 82, 11, 6, ub04.Field36b_OccurrenceSpan.ThroughDate);
// Box 37 - Blank
AddBlock(page, 90, 10, 9, ub04.Field37.Line1);
AddBlock(page, 90, 11, 9, ub04.Field37.Line2);
// Box 38 - Responsible Party
AddBlock(page, 2, 12, 48, ub04.Field38_ResponsibleParty.Line1);
AddBlock(page, 2, 13, 48, ub04.Field38_ResponsibleParty.Line2);
AddBlock(page, 2, 14, 48, ub04.Field38_ResponsibleParty.Line3);
AddBlock(page, 2, 15, 48, ub04.Field38_ResponsibleParty.Line4);
AddBlock(page, 2, 16, 48, ub04.Field38_ResponsibleParty.Line5);
// Box 39 - Value Codes
AddBlock(page, 53, 13, 2, ub04.Field39a_Value.Code);
AddBlock(page, 57, 13, 12, String.Format("{0:0.00}", ub04.Field39a_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 53, 14, 2, ub04.Field39b_Value.Code);
AddBlock(page, 57, 14, 12, String.Format("{0:0.00}", ub04.Field39b_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 53, 15, 2, ub04.Field39c_Value.Code);
AddBlock(page, 57, 15, 12, String.Format("{0:0.00}", ub04.Field39c_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 53, 16, 2, ub04.Field39d_Value.Code);
AddBlock(page, 57, 16, 12, String.Format("{0:0.00}", ub04.Field39d_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
// Box 40
AddBlock(page, 69, 13, 2, ub04.Field40a_Value.Code);
AddBlock(page, 72.5m, 13, 12, String.Format("{0:0.00}", ub04.Field40a_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 69, 14, 2, ub04.Field40b_Value.Code);
AddBlock(page, 72.5m, 14, 12, String.Format("{0:0.00}", ub04.Field40b_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 69, 15, 2, ub04.Field40c_Value.Code);
AddBlock(page, 72.5m, 15, 12, String.Format("{0:0.00}", ub04.Field40c_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 69, 16, 2, ub04.Field40d_Value.Code);
AddBlock(page, 72.5m, 16, 12, String.Format("{0:0.00}", ub04.Field40d_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
// Box 41 - Value Codes
AddBlock(page, 84, 13, 2, ub04.Field41a_Value.Code);
AddBlock(page, 88, 13, 12, String.Format("{0:0.00}", ub04.Field41a_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 84, 14, 2, ub04.Field41b_Value.Code);
AddBlock(page, 88, 14, 12, String.Format("{0:0.00}", ub04.Field41b_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 84, 15, 2, ub04.Field41c_Value.Code);
AddBlock(page, 88, 15, 12, String.Format("{0:0.00}", ub04.Field41c_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 84, 16, 2, ub04.Field41d_Value.Code);
AddBlock(page, 88, 16, 12, String.Format("{0:0.00}", ub04.Field41d_Value.Amount).Replace('.', ' '), TextAlignEnum.right);
}
// service lines
decimal y = 18 + (i % 22);
var line = ub04.ServiceLines[i];
// Box 42 - 49 - Service Lines
AddBlock(page, 2, y, 4, line.Field42_RevenueCode);
AddBlock(page, 7, y, 29, line.Field43_Description);
AddBlock(page, 37, y, 17, line.Field44_ProcedureCodes);
AddBlock(page, 56, y, 6, line.Field45_ServiceDate);
AddBlock(page, 64, y, 9, line.Field46_ServiceUnits, TextAlignEnum.right);
AddBlock(page, 74, y, 11, String.Format("{0:0.00}", line.Field47_TotalCharges).Replace('.',' '), TextAlignEnum.right);
AddBlock(page, 86, y, 11, String.Format("{0:0.00}", line.Field48_NonCoveredCharges).Replace('.',' '), TextAlignEnum.right);
AddBlock(page, 97, y, 2, line.Field49);
if (i % 22 == 21 || i == ub04.ServiceLines.Count - 1) // Footer
{
int pageIndex = 1 + ((i - 1) / 22);
AddBlock(page, 13, 40, 3, pageIndex.ToString(), TextAlignEnum.right);
AddBlock(page, 20, 40, 3, pageCount.ToString(), TextAlignEnum.right);
AddBlock(page, 74, 40, 11, String.Format("{0:0.00}", ub04.Field47_Line23_TotalCharges).Replace('.',' '), TextAlignEnum.right);
AddBlock(page, 86, 40, 11, String.Format("{0:0.00}", ub04.Field48_Line23_NonCoveredCharges).Replace('.',' '), TextAlignEnum.right);
// Box 50
AddBlock(page, 2, 42, 26, ub04.PayerA_Primary.Field50_PayerName);
AddBlock(page, 2, 43, 26, ub04.PayerB_Secondary.Field50_PayerName);
AddBlock(page, 2, 44, 26, ub04.PayerC_Tertiary.Field50_PayerName);
// Box 51
AddBlock(page, 29, 42, 17, ub04.PayerA_Primary.Field51_HealthPlanId);
AddBlock(page, 29, 43, 17, ub04.PayerB_Secondary.Field51_HealthPlanId);
AddBlock(page, 29, 44, 17, ub04.PayerC_Tertiary.Field51_HealthPlanId);
// Box 52 - Release of Info
AddBlock(page, 46.5m, 42, 2, ub04.PayerA_Primary.Field52_ReleaseOfInfoCertIndicator);
AddBlock(page, 46.5m, 43, 2, ub04.PayerB_Secondary.Field52_ReleaseOfInfoCertIndicator);
AddBlock(page, 46.5m, 44, 2, ub04.PayerC_Tertiary.Field52_ReleaseOfInfoCertIndicator);
// Box 53
AddBlock(page, 50, 42, 2, ub04.PayerA_Primary.Field53_AssignmentOfBenefitsCertIndicator);
AddBlock(page, 50, 43, 2, ub04.PayerB_Secondary.Field53_AssignmentOfBenefitsCertIndicator);
AddBlock(page, 50, 44, 2, ub04.PayerC_Tertiary.Field53_AssignmentOfBenefitsCertIndicator);
// Box 54
AddBlock(page, 54.25m, 42, 11, String.Format("{0:0.00}", ub04.PayerA_Primary.Field54_PriorPayments).Replace('.',' '), TextAlignEnum.right);
AddBlock(page, 54.25m, 43, 11, String.Format("{0:0.00}", ub04.PayerB_Secondary.Field54_PriorPayments).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 54.25m, 44, 11, String.Format("{0:0.00}", ub04.PayerC_Tertiary.Field54_PriorPayments).Replace('.', ' '), TextAlignEnum.right);
// Box 55
AddBlock(page, 66.5m, 42, 12, String.Format("{0:0.00}", ub04.PayerA_Primary.Field55_EstimatedAmountDue).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 66.5m, 43, 12, String.Format("{0:0.00}", ub04.PayerB_Secondary.Field55_EstimatedAmountDue).Replace('.', ' '), TextAlignEnum.right);
AddBlock(page, 66.5m, 44, 12, String.Format("{0:0.00}", ub04.PayerC_Tertiary.Field55_EstimatedAmountDue).Replace('.', ' '), TextAlignEnum.right);
// Box 56
AddBlock(page, 85, 41, 10, ub04.Field56_NationalProviderIdentifier);
// Box 57
AddBlock(page, 82, 42, 17, ub04.Field57_OtherProviderIdA);
AddBlock(page, 82, 43, 17, ub04.Field57_OtherProviderIdB);
AddBlock(page, 82, 44, 17, ub04.Field57_OtherProviderIdC);
// Box 58
AddBlock(page, 2, 46, 29, ub04.PayerA_Primary.Field58_InsuredsName);
AddBlock(page, 2, 47, 29, ub04.PayerB_Secondary.Field58_InsuredsName);
AddBlock(page, 2, 48, 29, ub04.PayerC_Tertiary.Field58_InsuredsName);
// Box 59
AddBlock(page, 33, 46, 2, ub04.PayerA_Primary.Field59_PatientRelationship);
AddBlock(page, 33, 47, 2, ub04.PayerB_Secondary.Field59_PatientRelationship);
AddBlock(page, 33, 48, 2, ub04.PayerC_Tertiary.Field59_PatientRelationship);
// Box 60
AddBlock(page, 36, 46, 23, ub04.PayerA_Primary.Field60_InsuredsUniqueId);
AddBlock(page, 36, 47, 23, ub04.PayerB_Secondary.Field60_InsuredsUniqueId);
AddBlock(page, 36, 48, 23, ub04.PayerC_Tertiary.Field60_InsuredsUniqueId);
// Box 61
AddBlock(page, 60, 46, 17, ub04.PayerA_Primary.Field61_GroupName);
AddBlock(page, 60, 47, 17, ub04.PayerB_Secondary.Field61_GroupName);
AddBlock(page, 60, 48, 17, ub04.PayerC_Tertiary.Field61_GroupName);
// Box 62
AddBlock(page, 78, 46, 21, ub04.PayerA_Primary.Field62_InsuredsGroupNumber);
AddBlock(page, 78, 47, 21, ub04.PayerB_Secondary.Field62_InsuredsGroupNumber);
AddBlock(page, 78, 48, 21, ub04.PayerC_Tertiary.Field62_InsuredsGroupNumber);
// Box 63
AddBlock(page, 2, 50, 35, ub04.Field63A_TreatmentAuthorizationCode);
AddBlock(page, 2, 51, 35, ub04.Field63B_TreatmentAuthorizationCode);
AddBlock(page, 2, 52, 35, ub04.Field63C_TreatmentAuthorizationCode);
// Box 64 - Document Control Number
AddBlock(page, 39, 50, 30, ub04.Field64A_DocumentControlNumber);
AddBlock(page, 39, 51, 30, ub04.Field64B_DocumentControlNumber);
AddBlock(page, 39, 52, 30, ub04.Field64C_DocumentControlNumber);
// Box 65 - Employer Name
AddBlock(page, 70, 50, 29, ub04.Field65a_EmployerName);
AddBlock(page, 70, 51, 29, ub04.Field65b_EmployerName);
AddBlock(page, 70, 52, 29, ub04.Field65c_EmployerName);
// Box 66 - ICD Version
AddBlock(page, 1, 54, 1, ub04.Field66_Version);
// Box 67 - Primary Diagnosis
AddBlock(page, 3, 53, 6, ub04.Field67_PrincipleDiagnosis.Code);
AddBlock(page, 10.5m, 53, 1, ub04.Field67_PrincipleDiagnosis.PresentOnAdmissionIndicator);
// Box 67A
AddBlock(page, 13, 53, 6, ub04.Field67A_Diagnosis.Code);
AddBlock(page, 20, 53, 1, ub04.Field67A_Diagnosis.PresentOnAdmissionIndicator);
// Box 67B
AddBlock(page, 22, 53, 6, ub04.Field67B_Diagnosis.Code);
AddBlock(page, 29.75m, 53, 1, ub04.Field67B_Diagnosis.PresentOnAdmissionIndicator);
// Box 67C
AddBlock(page, 32, 53, 6, ub04.Field67C_Diagnosis.Code);
AddBlock(page, 39.25m, 53, 1, ub04.Field67C_Diagnosis.PresentOnAdmissionIndicator);
// Box 67D
AddBlock(page, 42, 53, 6, ub04.Field67D_Diagnosis.Code);
AddBlock(page, 49m, 53, 1, ub04.Field67D_Diagnosis.PresentOnAdmissionIndicator);
// Box 67E
AddBlock(page, 51, 53, 6, ub04.Field67E_Diagnosis.Code);
AddBlock(page, 58.5m, 53, 1, ub04.Field67E_Diagnosis.PresentOnAdmissionIndicator);
// Box 67F
AddBlock(page, 61, 53, 6, ub04.Field67F_Diagnosis.Code);
AddBlock(page, 68m, 53, 1, ub04.Field67F_Diagnosis.PresentOnAdmissionIndicator);
// Box 67G
AddBlock(page, 70, 53, 6, ub04.Field67G_Diagnosis.Code);
AddBlock(page, 77.75m, 53, 1, ub04.Field67G_Diagnosis.PresentOnAdmissionIndicator);
// Box 67H
AddBlock(page, 80, 53, 6, ub04.Field67H_Diagnosis.Code);
AddBlock(page, 87.25m, 53, 1, ub04.Field67H_Diagnosis.PresentOnAdmissionIndicator);
// Box 67I
AddBlock(page, 3, 54, 6, ub04.Field67I_Diagnosis.Code);
AddBlock(page, 10.5m, 54, 1, ub04.Field67I_Diagnosis.PresentOnAdmissionIndicator);
// Box 67J
AddBlock(page, 13, 54, 6, ub04.Field67J_Diagnosis.Code);
AddBlock(page, 20, 54, 1, ub04.Field67J_Diagnosis.PresentOnAdmissionIndicator);
// Box 67K
AddBlock(page, 22, 54, 6, ub04.Field67K_Diagnosis.Code);
AddBlock(page, 29.75m, 54, 1, ub04.Field67K_Diagnosis.PresentOnAdmissionIndicator);
// Box 67L
AddBlock(page, 32, 54, 6, ub04.Field67L_Diagnosis.Code);
AddBlock(page, 39.25m, 54, 1, ub04.Field67L_Diagnosis.PresentOnAdmissionIndicator);
// Box 67M
AddBlock(page, 42, 54, 6, ub04.Field67M_Diagnosis.Code);
AddBlock(page, 49m, 54, 1, ub04.Field67M_Diagnosis.PresentOnAdmissionIndicator);
// Box 67N
AddBlock(page, 51, 54, 6, ub04.Field67N_Diagnosis.Code);
AddBlock(page, 58.5m, 54, 1, ub04.Field67N_Diagnosis.PresentOnAdmissionIndicator);
// Box 67O
AddBlock(page, 61, 54, 6, ub04.Field67O_Diagnosis.Code);
AddBlock(page, 68m, 54, 1, ub04.Field67O_Diagnosis.PresentOnAdmissionIndicator);
// Box 67P
AddBlock(page, 70, 54, 6, ub04.Field67P_Diagnosis.Code);
AddBlock(page, 77.75m, 54, 1, ub04.Field67P_Diagnosis.PresentOnAdmissionIndicator);
// Box 67Q
AddBlock(page, 80, 54, 6, ub04.Field67Q_Diagnosis.Code);
AddBlock(page, 87.25m, 54, 1, ub04.Field67Q_Diagnosis.PresentOnAdmissionIndicator);
// Box 68
AddBlock(page, 90, 53, 9, ub04.Field68.Line1);
AddBlock(page, 90, 54, 9, ub04.Field68.Line2);
// Box 69 - Admitting Diagnosis
AddBlock(page, 6, 55, 6, ub04.Field69_AdmittingDiagnosisCode.Code);
// Box 70 - Patient Reason Diagnosis
AddBlock(page, 21, 55, 6, ub04.Field70a_PatientReasonDiagnosisCode.Code);
AddBlock(page, 29, 55, 6, ub04.Field70b_PatientReasonDiagnosisCode.Code);
AddBlock(page, 38, 55, 6, ub04.Field70c_PatientReasonDiagnosisCode.Code);
// Box 71 - PPS Code
AddBlock(page, 51, 55, 5, ub04.Field71_PPSCode);
// Box 72 - External Cause of Injury
AddBlock(page, 59, 55, 6, ub04.Field72a_ExternalCauseOfInjury.Code);
AddBlock(page, 67m, 55, 1, ub04.Field72a_ExternalCauseOfInjury.PresentOnAdmissionIndicator);
AddBlock(page, 69, 55, 6, ub04.Field72b_ExternalCauseOfInjury.Code);
AddBlock(page, 76.75m, 55, 1, ub04.Field72b_ExternalCauseOfInjury.PresentOnAdmissionIndicator);
AddBlock(page, 79, 55, 6, ub04.Field72c_ExternalCauseOfInjury.Code);
AddBlock(page, 86.25m, 55, 1, ub04.Field72c_ExternalCauseOfInjury.PresentOnAdmissionIndicator);
// Box 73 - Blank
AddBlock(page, 89, 55, 10, ub04.Field73);
// Box 74
AddBlock(page, 2, 57, 8, ub04.Field74_PrincipalProcedure.Code);
AddBlock(page, 12, 57, 6, ub04.Field74_PrincipalProcedure.Date);
AddBlock(page, 20, 57, 8, ub04.Field74a_OtherProcedure.Code);
AddBlock(page, 29, 57, 6, ub04.Field74a_OtherProcedure.Date);
AddBlock(page, 38, 57, 8, ub04.Field74b_OtherProcedure.Code);
AddBlock(page, 48, 57, 6, ub04.Field74b_OtherProcedure.Date);
AddBlock(page, 2, 59, 8, ub04.Field74c_OtherProcedure.Code);
AddBlock(page, 12, 59, 6, ub04.Field74c_OtherProcedure.Date);
AddBlock(page, 20, 59, 8, ub04.Field74d_OtherProcedure.Code);
AddBlock(page, 29, 59, 6, ub04.Field74d_OtherProcedure.Date);
AddBlock(page, 38, 59, 8, ub04.Field74e_OtherProcedure.Code);
AddBlock(page, 48, 59, 6, ub04.Field74e_OtherProcedure.Date);
// Box 75
AddBlock(page, 56, 56, 4, ub04.Field75.Line1);
AddBlock(page, 56, 57, 4, ub04.Field75.Line2);
AddBlock(page, 56, 58, 4, ub04.Field75.Line3);
AddBlock(page, 56, 59, 4, ub04.Field75.Line4);
// Box 76
AddBlock(page, 72, 56, 10, ub04.Field76_AttendingPhysician.Npi);
AddBlock(page, 86, 56, 2, ub04.Field76_AttendingPhysician.IdentifierQualifier);
AddBlock(page, 89, 56, 10, ub04.Field76_AttendingPhysician.Identifier);
AddBlock(page, 64, 57, 18, ub04.Field76_AttendingPhysician.LastName);
AddBlock(page, 86, 57, 13, ub04.Field76_AttendingPhysician.FirstName);
// Box 77
AddBlock(page, 72, 58, 10, ub04.Field77_OperatingPhysician.Npi);
AddBlock(page, 86, 58, 2, ub04.Field77_OperatingPhysician.IdentifierQualifier);
AddBlock(page, 89, 58, 10, ub04.Field77_OperatingPhysician.Identifier);
AddBlock(page, 64, 59, 18, ub04.Field77_OperatingPhysician.LastName);
AddBlock(page, 86, 59, 13, ub04.Field77_OperatingPhysician.FirstName);
// Box 78
AddBlock(page, 72, 60, 10, ub04.Field78_OtherProvider.Npi);
AddBlock(page, 86, 60, 2, ub04.Field78_OtherProvider.IdentifierQualifier);
AddBlock(page, 89, 60, 10, ub04.Field78_OtherProvider.Identifier);
AddBlock(page, 64, 61, 18, ub04.Field78_OtherProvider.LastName);
AddBlock(page, 86, 61, 13, ub04.Field78_OtherProvider.FirstName);
// Box 79
AddBlock(page, 72, 62, 10, ub04.Field79_OtherProvider.Npi);
AddBlock(page, 86, 62, 2, ub04.Field79_OtherProvider.IdentifierQualifier);
AddBlock(page, 89, 62, 10, ub04.Field79_OtherProvider.Identifier);
AddBlock(page, 64, 63, 18, ub04.Field79_OtherProvider.LastName);
AddBlock(page, 86, 63, 13, ub04.Field79_OtherProvider.FirstName);
// Box 80
AddBlock(page, 2, 61, 27, ub04.Field80_Remarks.Line1);
AddBlock(page, 2, 62, 27, ub04.Field80_Remarks.Line2);
AddBlock(page, 2, 63, 27, ub04.Field80_Remarks.Line3);
// Box 81
AddBlock(page, 32, 60, 2, ub04.Field81a.Qualifier);
AddBlock(page, 35, 60, 10, ub04.Field81a.Code1);
AddBlock(page, 48, 60, 12, ub04.Field81a.Code2);
AddBlock(page, 32, 61, 2, ub04.Field81b.Qualifier);
AddBlock(page, 35, 61, 10, ub04.Field81b.Code1);
AddBlock(page, 48, 61, 12, ub04.Field81b.Code2);
AddBlock(page, 32, 62, 2, ub04.Field81c.Qualifier);
AddBlock(page, 35, 62, 10, ub04.Field81c.Code1);
AddBlock(page, 48, 62, 12, ub04.Field81c.Code2);
AddBlock(page, 32, 63, 2, ub04.Field81d.Qualifier);
AddBlock(page, 35, 63, 10, ub04.Field81d.Code1);
AddBlock(page, 48, 63, 12, ub04.Field81d.Code2);
// reorder by locations;
page.Blocks = page.Blocks.OrderBy(bl => bl.Top).ToList();
}
}
return pages;
}
