@extends('admin.layout.master') @section('content')
Espace Décision / Refus
Refuser un Médicament
Examen minutieux motivant le refus de la demande pharmaceutique.
@if ($errors->any())
    @foreach ($errors->all() as $error)
  • {{ $error }}
  • @endforeach
@endif
{{ Form::open(['route' => 'admin.medecinconseil.refuserententePha', 'method' => 'POST', 'onsubmit'=>'showOverlay()', 'id' => 'form_entente']) }}
Détails de la demande
{{ Form::text('id', $ententeprealable->first()->id, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('libelleMedicament', $ententeprealable->first()->libelleMedicament, ['readonly' => 'true', 'class' => 'input-chic input-highlight']) }}
{{ Form::text('dateSysteme', $ententeprealable->first()->dateSysteme, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('prestataire', $ententeprealable->first()->prestataire, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('beneficiaire', $ententeprealable->first()->beneficiaire.' / '.$ententeprealable->first()->numeroBeneficiaire, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('motifReel', $ententeprealable->first()->motifReel, ['class' => 'input-chic', 'style' => 'border-color: rgba(231,76,60,0.5) !important;', 'id' => 'motifReel', 'placeholder' => 'Motif de Refus Assureur']) }}
{{ Form::text('motifRefusAssure', $ententeprealable->first()->motifRefusAssure, ['class' => 'input-chic', 'style' => 'border-color: rgba(231,76,60,0.5) !important;', 'id' => 'motifRefusAssure', 'placeholder' => 'Motif de Refus à communiquer à l\'assuré']) }}
État des Consommations
@if($baseTarification=="IND")
Plafond Individuel
{{ Form::text('plafond', number_format($college->first()->plafond,0,'',' '), ['readonly' => 'true']) }}
Conso. Individuelle
{{ Form::text('consommation', number_format($college->first()->consommation,0,'',' '), ['readonly' => 'true']) }}
Solde Individuel Restant
{{ Form::text('soldeConsommation', number_format($college->first()->soldeConsommation,0,'',' '), ['readonly' => 'true']) }}
@else
Plafond Famille
{{ Form::text('plafond', number_format($police->first()->plafond,0,'',' '), ['readonly' => 'true']) }}
Conso. Famille
{{ Form::text('consommation', number_format($police->first()->consommation,0,'',' '), ['readonly' => 'true']) }}
Solde Famille Restant
{{ Form::text('soldeConsommation', number_format($police->first()->soldeConsommation,0,'',' '), ['readonly' => 'true']) }}
@endif
{{ Form::close() }}
Afficher / Masquer les Garanties Afficher / Masquer les Actes Plafonnés
@section('scripts') @endsection @endsection