{{$request->head_note}} |
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| HEALTH SECTOR REFERENCE INFORMATION |
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| Provider Code | User Data | Contract/Coverage Info | Authorization/MIPRES Nos. | Payment Info | |
|---|---|---|---|---|---|
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{{$item->provider_code}} |
@if($item->identification_number && $item->first_name && $item->surname && $item->health_type_document_identification_id)
ID No: {{$item->identification_number}} Name: {{$item->first_name}} {{$item->middle_name}} {{$item->surname}} {{$item->second_surname}} Document Type: {{$item->health_type_document_identification()->name}} User Type: {{$item->health_type_user()->name}} |
@else
ID No: Name: Document Type: User Type: |
@endif
Contracting Modality: {{$item->health_contracting_payment_method()->name}} Contract No: {{$item->contract_number}} Coverage: {{$item->health_coverage()->name}} |
Authorization Nos.: {{$item->autorization_numbers}} MIPRES No: {{$item->mipres}} MIPRES Delivery: {{$item->mipres_delivery}} Policy No: {{$item->policy_number}} |
Copayment: {{number_format($item->co_payment, 2)}} Moderating Fee: {{number_format($item->moderating_fee, 2)}} Shared Payments: {{number_format($item->shared_payment, 2)}} Advances: {{number_format($item->advance_payment, 2)}} |
| # | Code | Description | @if($showPurchaseOrderColumn)Purchase Order | @endifQuantity | UM | Unit Value | @if(isset($request['deliveryterms']))Unit Value USD | @endifVAT/IC | @if(isset($request['deliveryterms']))VAT/IC USD | @endifDiscount | @if(isset($request['deliveryterms']))Discount USD | @endif% | Item Value | @if(isset($request['deliveryterms']))Item Value USD | @endif||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| {{$ItemNro}} | {{$item['code']}} | {{$item['description']}} | {{number_format($item['price_amount'], 2)}} | @if(isset($request['deliveryterms'])){{number_format($item['price_amount'] / $trmValue, 2)}} | @endif{{isset($item['tax_totals'][0]['tax_amount']) ? number_format($item['tax_totals'][0]['tax_amount'], 2) : '0.00'}} | @if(isset($request['deliveryterms'])){{isset($item['tax_totals'][0]['tax_amount']) ? number_format($item['tax_totals'][0]['tax_amount'] / $trmValue, 2) : '0.00'}} | @endif @if(isset($item['allowance_charges'])){{number_format($item['allowance_charges'][0]['amount'], 2)}} | @if(isset($request['deliveryterms'])){{number_format($item['allowance_charges'][0]['amount'] / $trmValue, 2)}} | @endif @else0.00 | @if(isset($request['deliveryterms']))0.00 | @endif @endif@if(isset($item['allowance_charges']) && floatval($item['allowance_charges'][0]['base_amount']) != 0) {{ number_format(($item['allowance_charges'][0]['amount'] * 100) / $item['allowance_charges'][0]['base_amount'], 2) }} @else 0.00 @endif | {{number_format($item['invoiced_quantity'] * $item['price_amount'], 2)}} | @if(isset($request['deliveryterms'])){{number_format(($item['invoiced_quantity'] * $item['price_amount']) / $trmValue, 2)}} | @endif @else{{$ItemNro}} | {{$item['code']}} |
@if(isset($item['notes']))
{{$item['description']}}
{{$item['notes']}} @else {{$item['description']}} @endif |
@if($showPurchaseOrderColumn)
@if(isset($item['purchase_order_number']) && $item['purchase_order_number']) {{$item['purchase_order_number']}} @endif | @endif{{number_format($item['invoiced_quantity'], 2)}} | {{$um->findOrFail($item['unit_measure_id'])['name']}} | {{number_format(($item['line_extension_amount'] / $item['invoiced_quantity']), 2)}} | @if(isset($request['deliveryterms'])){{number_format(($item['line_extension_amount'] / $item['invoiced_quantity']) / $trmValue, 2)}} | @endif @if(isset($item['tax_totals'])){{number_format($item['tax_totals'][0]['tax_amount'] / $item['invoiced_quantity'], 2)}} | @if(isset($request['deliveryterms'])){{number_format(($item['tax_totals'][0]['tax_amount'] / $item['invoiced_quantity']) / $trmValue, 2)}} | @endif @elseE | @if(isset($request['deliveryterms']))E | @endif @endif @if(isset($item['allowance_charges'])){{number_format($item['allowance_charges'][0]['amount'], 2)}} | @if(isset($request['deliveryterms'])){{number_format($item['allowance_charges'][0]['amount'] / $trmValue, 2)}} | @endif @else0.00 | @if(isset($request['deliveryterms']))0.00 | @endif @endif@if(isset($item['allowance_charges']) && floatval($item['allowance_charges'][0]['base_amount']) != 0) {{ number_format(($item['allowance_charges'][0]['amount'] * 100) / $item['allowance_charges'][0]['base_amount'], 2) }} @else 0.00 @endif | {{number_format($item['line_extension_amount'], 2)}} | @if(isset($request['deliveryterms'])){{number_format($item['line_extension_amount'] / $trmValue, 2)}} | @endif @endif
| Taxes | Withholdings | Totals | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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@php // Start with payable_amount $totalAmount = $request->legal_monetary_totals['payable_amount']; // Check for previous_balance if (isset($request->previous_balance)) { $totalAmount += $request->previous_balance; } // Check for withholdings and subtract if (isset($TotalRetenciones)) { $totalAmount -= $TotalRetenciones; } // Round total to two decimals $totalAmount = round($totalAmount, 2); $totalAmountUSD = isset($request['deliveryterms']) ? round($totalAmount / $trmValue, 2) : 0; // Define currency $idcurrency = $request->idcurrency ?? null; @endphp @if(isset($request['deliveryterms']))
AMOUNT IN WORDS: {{$Varios->convertir($totalAmountUSD, $idcurrency, 'en')}} *********.
@elseAMOUNT IN WORDS: {{$Varios->convertir($totalAmount, $idcurrency, 'en')}} *********.
@endif| Bank accounts for payment | |
|---|---|
| Bank | Account Number |
| {{$cuenta['bank_description']}} | {{$cuenta['number']}} |
NOTES:
{{$notes}}
PLEASE REPORT PAYMENT TO PHONE {{$company->phone}} or email {{$user->email}}
ACCEPTANCE SIGNATURE:
ID:
DATE:
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