/*
* 2011/8/16, jhalliday - New Data Model for 837P (Professional) claim.
*
* Team: dstrubhar, jhalliday and epkrause
*
* Purpose:
* To create a C# object model that will serve as a container for the X12 837P data
* AS ENTERED from a HCFA 1500 Professional claim form.
*
* Goal:
* The team has the overall goal of creating tools that can be used to consume and
* manipulate X12 messages (AKA files/documents) without the need to have a big project
* budget. For that reason, this and the related X12 Parser project tools are all open
* source and freely usable.
*/
public HCFA1500Claim()
{
if (Field03_PatientsDateOfBirth == null) Field03_PatientsDateOfBirth = new FormDate();
if (Field09b_OtherInsuredsDateOfBirth == null) Field09b_OtherInsuredsDateOfBirth = new FormDate();
if (Field11a_InsuredsDateOfBirth == null) Field11a_InsuredsDateOfBirth = new FormDate();
if (Field12_PatientsOrAuthorizedSignatureDate == null) Field12_PatientsOrAuthorizedSignatureDate = new FormDate();
if (Field14_DateOfCurrentIllnessInjuryOrPregnancy == null) Field14_DateOfCurrentIllnessInjuryOrPregnancy = new FormDate();
if (Field15_DatePatientHadSameOrSimilarIllness == null) Field15_DatePatientHadSameOrSimilarIllness = new FormDate();
if (Field16_DatePatientUnableToWork_Start == null) Field16_DatePatientUnableToWork_Start = new FormDate();
if (Field16_DatePatientUnableToWork_End == null) Field16_DatePatientUnableToWork_End = new FormDate();
if (Field18_HospitalizationDateFrom == null) Field18_HospitalizationDateFrom = new FormDate();
if (Field18_HospitalizationDateTo == null) Field18_HospitalizationDateTo = new FormDate();
if (Field24_ServiceLines == null) Field24_ServiceLines = new List<HCFA1500ServiceLine>();
}
/*
* 2011/8/16, jhalliday - New Data Model for 837P (Professional) claim.
*
* Team: dstrubhar, jhalliday and epkrause
*
* Purpose:
* To create a C# object model that will serve as a container for the X12 837P data
* AS ENTERED from a HCFA 1500 Professional claim form.
*
* Goal:
* The team has the overall goal of creating tools that can be used to consume and
* manipulate X12 messages (AKA files/documents) without the need to have a big project
* budget. For that reason, this and the related X12 Parser project tools are all open
* source and freely usable.
*/
public HCFA1500Claim()
{
if (Field03_PatientsDateOfBirth == null)
{
Field03_PatientsDateOfBirth = new FormDate();
}
if (Field09b_OtherInsuredsDateOfBirth == null)
{
Field09b_OtherInsuredsDateOfBirth = new FormDate();
}
if (Field11a_InsuredsDateOfBirth == null)
{
Field11a_InsuredsDateOfBirth = new FormDate();
}
if (Field12_PatientsOrAuthorizedSignatureDate == null)
{
Field12_PatientsOrAuthorizedSignatureDate = new FormDate();
}
if (Field14_DateOfCurrentIllnessInjuryOrPregnancy == null)
{
Field14_DateOfCurrentIllnessInjuryOrPregnancy = new FormDate();
}
if (Field15_DatePatientHadSameOrSimilarIllness == null)
{
Field15_DatePatientHadSameOrSimilarIllness = new FormDate();
}
if (Field16_DatePatientUnableToWork_Start == null)
{
Field16_DatePatientUnableToWork_Start = new FormDate();
}
if (Field16_DatePatientUnableToWork_End == null)
{
Field16_DatePatientUnableToWork_End = new FormDate();
}
if (Field18_HospitalizationDateFrom == null)
{
Field18_HospitalizationDateFrom = new FormDate();
}
if (Field18_HospitalizationDateTo == null)
{
Field18_HospitalizationDateTo = new FormDate();
}
if (Field24_ServiceLines == null)
{
Field24_ServiceLines = new List <HCFA1500ServiceLine>();
}
}
private List<AbstractFormElement> MapValueExpressions(List<string> valueExpressions)
{
if (valueExpressions != null && valueExpressions.Count > 0)
{
List<AbstractFormElement> valueElements = new List<AbstractFormElement>();
foreach (var item in valueExpressions)
{
Regex blockRx = new Regex("{{block:(.*?)}}");
Regex dateRx = new Regex("{{date:(.*?)}}");
if (blockRx.Match(item).Success)
{
FormTextBlock textBlock = new FormTextBlock();
textBlock.Name = item.Replace("{{block:", string.Empty).Replace("}}", string.Empty);
textBlock.Expression = item;
textBlock.Text = string.Empty;
valueElements.Add(textBlock);
}
else if (dateRx.Match(item).Success)
{
FormDate date = new FormDate();
date.Name = item.Replace("{{date:", string.Empty).Replace("}}", string.Empty); ;
date.Expression = item;
date.Date = DateTime.Now;
valueElements.Add(date);
}
else
{
FormTextBox textBox = new FormTextBox();
textBox.Name = item.Replace("{{", string.Empty).Replace("}}", string.Empty);
textBox.Expression = item;
textBox.Text = string.Empty;
valueElements.Add(textBox);
}
}
return valueElements;
}
return null;
}
private void ShowForm(FieldType fieldType)
{
switch (fieldType)
{
case FieldType.Date:
var formDate = new FormDate();
formDate.ShowDialogDate(entityDesigner);
break;
case FieldType.Bool:
var formBool = new FormBool();
formBool.ShowDialogBool(entityDesigner);
break;
case FieldType.Number:
case FieldType.Money:
var formMoney = new FormMoney();
formMoney.MaxValue = entityDesigner.MaxValue;
formMoney.ShowDialogMoney(entityDesigner);
break;
case FieldType.String:
var formString = new FormString();
formString.ShowDialogString(entityDesigner);
break;
case FieldType.None:
break;
case FieldType.Constraint:
break;
default:
break;
}
}
public List <UIElement> BuildUIElements(List <AbstractFormElement> list)
{
Thickness defaultMargin = new Thickness(20, 5, 20, 5);
List <UIElement> uiList = new List <UIElement>();
foreach (var item in list)
{
if (item is FormCheckBox)
{
FormCheckBox formCheckBox = item as FormCheckBox;
Grid grid = new Grid();
ColumnDefinition columnDefinition1 = new ColumnDefinition();
columnDefinition1.Width = new GridLength(1.0, GridUnitType.Star);
ColumnDefinition columnDefinition2 = new ColumnDefinition();
columnDefinition2.Width = new GridLength(1.0, GridUnitType.Star);
grid.ColumnDefinitions.Add(columnDefinition1);
grid.ColumnDefinitions.Add(columnDefinition2);
CheckBox checkBox = new CheckBox();
checkBox.Margin = defaultMargin;
Binding isChecked = new Binding("IsChecked");
isChecked.Source = formCheckBox;
isChecked.Mode = BindingMode.TwoWay;
checkBox.SetBinding(CheckBox.IsCheckedProperty, isChecked);
TextBlock textBlock = new TextBlock();
textBlock.TextWrapping = TextWrapping.Wrap;
textBlock.Text = formCheckBox.Text;
checkBox.Content = textBlock;
Grid.SetColumnSpan(checkBox, 2);
grid.Children.Add(checkBox);
uiList.Add(grid);
}
if (item is FormDropDown)
{
FormDropDown formDropDown = item as FormDropDown;
Grid grid = new Grid();
ColumnDefinition columnDefinition1 = new ColumnDefinition();
columnDefinition1.Width = new GridLength(1.0, GridUnitType.Star);
ColumnDefinition columnDefinition2 = new ColumnDefinition();
columnDefinition2.Width = new GridLength(2.0, GridUnitType.Star);
grid.ColumnDefinitions.Add(columnDefinition1);
grid.ColumnDefinitions.Add(columnDefinition2);
grid.HorizontalAlignment = HorizontalAlignment.Stretch;
grid.VerticalAlignment = VerticalAlignment.Stretch;
TextBlock textBlock = new TextBlock();
textBlock.Margin = defaultMargin;
textBlock.FontWeight = FontWeights.Bold;
Binding text = new Binding("Name");
text.Source = formDropDown;
text.Mode = BindingMode.OneWay;
textBlock.SetBinding(TextBlock.TextProperty, text);
ComboBox comboBox = new ComboBox();
comboBox.Margin = defaultMargin;
Binding options = new Binding("Options");
options.Source = formDropDown;
options.Mode = BindingMode.TwoWay;
comboBox.SetBinding(ComboBox.ItemsSourceProperty, options);
Binding selectedIndex = new Binding("SelectedIndex");
selectedIndex.Source = formDropDown;
selectedIndex.Mode = BindingMode.TwoWay;
comboBox.SetBinding(ComboBox.SelectedIndexProperty, selectedIndex);
Binding selectedValue = new Binding("SelectedValue");
selectedValue.Source = formDropDown;
selectedValue.Mode = BindingMode.OneWay;
comboBox.SetBinding(ComboBox.SelectedValueProperty, selectedValue);
Grid.SetColumn(textBlock, 0);
Grid.SetColumn(comboBox, 1);
grid.Children.Add(textBlock);
grid.Children.Add(comboBox);
uiList.Add(grid);
}
if (item is FormRadioButton)
{
FormRadioButton formRadioButton = item as FormRadioButton;
StackPanel stackPanel = new StackPanel();
stackPanel.HorizontalAlignment = HorizontalAlignment.Stretch;
stackPanel.VerticalAlignment = VerticalAlignment.Stretch;
for (int i = 0; i < formRadioButton.Options.Count; i++)
{
TextBlock textBlock = new TextBlock();
textBlock.TextWrapping = TextWrapping.Wrap;
textBlock.Text = formRadioButton.Options[i];
RadioButton radioButton = new RadioButton();
radioButton.Margin = defaultMargin;
radioButton.Content = textBlock;
radioButton.GroupName = item.Name;
radioButton.Checked += (sender, args) =>
{
formRadioButton.SelectedIndex = formRadioButton.Options.IndexOf(textBlock.Text);
};
if (i == formRadioButton.SelectedIndex)
{
radioButton.IsChecked = true;
}
RowDefinition rowDefinition = new RowDefinition();
stackPanel.Children.Add(radioButton);
}
GroupBox groupBox = new GroupBox();
groupBox.Header = item.Name;
groupBox.Content = stackPanel;
groupBox.Margin = defaultMargin;
uiList.Add(groupBox);
}
if (item is FormTextBox)
{
FormTextBox formTextBox = item as FormTextBox;
Grid grid = new Grid();
ColumnDefinition columnDefinition1 = new ColumnDefinition();
columnDefinition1.Width = new GridLength(1.0, GridUnitType.Star);
ColumnDefinition columnDefinition2 = new ColumnDefinition();
columnDefinition2.Width = new GridLength(2.0, GridUnitType.Star);
grid.ColumnDefinitions.Add(columnDefinition1);
grid.ColumnDefinitions.Add(columnDefinition2);
grid.HorizontalAlignment = HorizontalAlignment.Stretch;
grid.VerticalAlignment = VerticalAlignment.Stretch;
TextBlock textBlock = new TextBlock();
textBlock.FontWeight = FontWeights.Bold;
textBlock.Margin = defaultMargin;
Binding label = new Binding("Name");
label.Source = formTextBox;
label.Mode = BindingMode.OneWay;
textBlock.SetBinding(TextBlock.TextProperty, label);
TextBox textBox = new TextBox();
textBox.Margin = defaultMargin;
Binding text = new Binding("Text");
text.Source = formTextBox;
text.Mode = BindingMode.TwoWay;
text.UpdateSourceTrigger = UpdateSourceTrigger.PropertyChanged;
textBox.SetBinding(TextBox.TextProperty, text);
textBox.Text = item.Name;
Grid.SetColumn(textBlock, 0);
Grid.SetColumn(textBox, 1);
grid.Children.Add(textBlock);
grid.Children.Add(textBox);
uiList.Add(grid);
}
if (item is FormTextBlock)
{
FormTextBlock formTextBlock = item as FormTextBlock;
StackPanel stackPanel = new StackPanel();
stackPanel.Orientation = Orientation.Vertical;
stackPanel.HorizontalAlignment = HorizontalAlignment.Stretch;
stackPanel.VerticalAlignment = VerticalAlignment.Stretch;
stackPanel.Margin = defaultMargin;
TextBlock textBlock = new TextBlock();
textBlock.FontWeight = FontWeights.Bold;
textBlock.TextWrapping = TextWrapping.Wrap;
Binding label = new Binding("Name");
label.Source = formTextBlock;
label.Mode = BindingMode.OneWay;
textBlock.SetBinding(TextBlock.TextProperty, label);
TextBox textBox = new TextBox();
textBox.MinLines = 5;
textBox.AcceptsReturn = true;
textBox.AcceptsTab = true;
textBox.TextWrapping = TextWrapping.Wrap;
Binding text = new Binding("Text");
text.Source = formTextBlock;
text.Mode = BindingMode.TwoWay;
text.UpdateSourceTrigger = UpdateSourceTrigger.PropertyChanged;
textBox.SetBinding(TextBox.TextProperty, text);
textBox.Text = item.Name;
stackPanel.Children.Add(textBlock);
stackPanel.Children.Add(textBox);
uiList.Add(stackPanel);
}
if (item is FormDate)
{
FormDate formDate = item as FormDate;
Grid grid = new Grid();
ColumnDefinition columnDefinition1 = new ColumnDefinition();
columnDefinition1.Width = new GridLength(1.0, GridUnitType.Star);
ColumnDefinition columnDefinition2 = new ColumnDefinition();
columnDefinition2.Width = new GridLength(2.0, GridUnitType.Star);
grid.ColumnDefinitions.Add(columnDefinition1);
grid.ColumnDefinitions.Add(columnDefinition2);
grid.HorizontalAlignment = HorizontalAlignment.Stretch;
grid.VerticalAlignment = VerticalAlignment.Stretch;
TextBlock textBlock = new TextBlock();
textBlock.FontWeight = FontWeights.Bold;
textBlock.Margin = defaultMargin;
textBlock.TextWrapping = TextWrapping.Wrap;
Binding label = new Binding("Name");
label.Source = formDate;
label.Mode = BindingMode.OneWay;
textBlock.SetBinding(TextBlock.TextProperty, label);
DatePicker datePicker = new DatePicker();
datePicker.Margin = defaultMargin;
Binding date = new Binding("Date");
date.Source = formDate;
date.Mode = BindingMode.TwoWay;
date.UpdateSourceTrigger = UpdateSourceTrigger.PropertyChanged;
datePicker.SetBinding(DatePicker.SelectedDateProperty, date);
Grid.SetColumn(textBlock, 0);
Grid.SetColumn(datePicker, 1);
grid.Children.Add(textBlock);
grid.Children.Add(datePicker);
uiList.Add(grid);
}
}
return(uiList);
}
public FormViewer(Form form)
{
InitializeComponent();
form.InitSections();
this.form = form;
this.Title = form.Name;
layout = new StackLayout();
layout.Orientation = StackOrientation.Vertical;
foreach (Section section in form.sections)
{
FormSectionLabel lblSection = new FormSectionLabel();
lblSection.Text = section.text;
layout.Children.Add(lblSection);
//loop through each child control inside the section
foreach (Field field in section.fields)
{
//create label
FormLabel lblText = new FormLabel(field);
lblText.Text = field.text;
layout.Children.Add(lblText);
//create field
switch (field.type)
{
case "text":
FormEntry entText = new FormEntry(field, lblText);
layout.Children.Add(entText);
entText.ClassId = field.id.ToString();
if (field.value != null && !String.IsNullOrWhiteSpace(field.value))
{
entText.Text = field.value;
}
break;
case "number":
FormEntry entNumber = new FormEntry(field, lblText)
{
Placeholder = "",
Keyboard = Keyboard.Numeric,
ClassId = field.id.ToString()
};
if (field.value != null && !String.IsNullOrWhiteSpace(field.value))
{
entNumber.Text = field.value;
}
layout.Children.Add(entNumber);
break;
case "radio":
FormDropDownList entPicker = new FormDropDownList(field, lblText)
{
Title = "Select...",
ClassId = field.id.ToString()
};
foreach (string pickeritem in field.options)
{
entPicker.Items.Add(pickeritem);
}
if (field.value != null && !String.IsNullOrWhiteSpace(field.value))
{
entPicker.SelectedIndex = entPicker.Items.IndexOf(entPicker.Items.FirstOrDefault(i => i.ToString() == field.value));
}
layout.Children.Add(entPicker);
break;
case "date":
FormDate entDate = new FormDate(field, lblText)
{
Format = "MMMM dd, yyyy",
ClassId = field.id.ToString()
};
if (field.value != null && !String.IsNullOrWhiteSpace(field.value))
{
entDate.Date = DateTime.Parse(field.value);
}
layout.Children.Add(entDate);
break;
case "boolean":
FormBoolean entToggle = new FormBoolean(field, lblText)
{
ClassId = field.id.ToString()
};
if (field.value != null && !String.IsNullOrWhiteSpace(field.value))
{
entToggle.IsToggled = field.value.Trim().ToLower() == "true";
}
layout.Children.Add(entToggle);
break;
}
}
}
FormContent.Content = layout;
// Bind the Help and Complete buttons
btnHelp.Clicked += (sender, args) => {
DisplayAlert("Help", "You have been alerted", "OK", "Cancel");
};
btnComplete.Clicked += (sender, args) =>
{
// if all fields are complete, set to complete status
this.form.status2 = FormStatus.Complete;
// Check that all required fields are valid
if (AreAllFieldsValid())
{
this.form.status2 = FormStatus.Complete;
Navigation.PopAsync();
}
else
{
DisplayAlert("Form Invalid", "This form could not be marked as complete because there was invalid data entered", "Ok");
}
};
}
