{% extends "patient/card/card_base.html.twig" %}

{% block content %}
<div class="container">
    <div class="row">
        <div class="col-4">{{ "Patient Balance Due"|xlt }}</div>
        <div class="col">{{ patientBalance|money|text }}</div>
    </div>
    <div class="row">
        <div class="col-4">{{ "Insurance Balance Due"|xlt }}</div>
        <div class="col">{{ insuranceBalance|money|text }}</div>
    </div>
    <div class="row">
        <div class="col-4">{{ "Total Balance Due"|xlt }}</div>
        <div class="col">{{ totalBalance|money|text }}</div>
    </div>

    {% if unallocated > 0 %}
    <div class="row">
        <div class="col-4">{{ "Unallocated Patient Pre-Payment"|xlt }}</div>
        <div class="col">{{ unallocated|money|text }}</font></div>
    </div>
    {% endif %}

    {% if collectionBalance > 0 %}
    <div class="row alert-danger">
        <div class="col-4">{{ "Collection Balance"|xlt }}</div>
        <div class="col">{{ collectionBalance|money|text }}</font></div>
    </div>
    {% endif %}

    {% if billingNote %}
    <div class="row">
        <div class="col-4">{{ "Billing Note"|xlt }}</div>
        <div class="col">{{ billingNote|text }}</div>
    </div>
    {% endif %}
    {% if provider %}
    <div class="row">
        <div class="col-4">{{ "Primary Insurance"|xlt }}</div>
        <div class="col">{{ insName|text }}</div>
    </div>
        {% if copay %}
        <div class="row">
            <div class="col-4">{{ "Copay"|xlt }}</div>
            <div class="col">{{ copay|text }}</div>
        </div>
        {% endif %}
    <div class="row">
        <div class="col-4">{{ "Effective Date"|xlt }}</div>
        <div class="col">{{ effDate|shortDate|text }}</div>
    </div>
    <div class="row">
        <div class="col-4">{{ "Effective Date End"|xlt }}</div>
        <div class="col">{{ effDateEnd|shortDate|text }}</div>
    </div>
    {% endif %}

</div>
{% endblock %}