| 1 | <xsl:if test="a:ContinuityOfCareRecord/a:Body/a:Payers">
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| 2 | <component>
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| 3 | <section>
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| 4 | <templateId root="2.16.840.1.113883.10.20.1.9"/>
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| 5 | <code code="48768-6" codeSystem="2.16.840.1.113883.6.1"/>
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| 6 | <title>Insurance</title>
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| 7 | <text>
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| 8 | <table>
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| 9 | <tbody>
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| 10 | <tr>
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| 11 | <th>Type</th>
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| 12 | <th>Date</th>
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| 13 | <th>Identification Numbers</th>
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| 14 | <th>Payment Provider</th>
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| 15 | <th>Subscriber</th>
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| 16 | <th>Source</th>
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| 17 | </tr>
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| 18 | <xsl:for-each select="/a:ContinuityOfCareRecord/a:Body/a:Payers/a:Payer">
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| 19 | <tr>
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| 20 | <td>
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| 21 | <xsl:value-of select="a:Type/a:Text"/>
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| 22 | </td>
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| 23 | <td>
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| 24 | <xsl:call-template name="date:format-date">
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| 25 | <xsl:with-param name="date-time" select="a:DateTime/a:ExactDateTime"/>
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| 26 | </xsl:call-template>
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| 27 | </td>
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| 28 | <td>
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| 29 | <xsl:for-each select="a:IDs">
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| 30 | <xsl:value-of select="a:Type/a:Text"/>:<xsl:text xml:space="preserve"> </xsl:text><xsl:value-of select="a:ID"/><br/>
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| 31 | </xsl:for-each>
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| 32 | </td>
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| 33 | <td>
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| 34 | <xsl:call-template name="actorName">
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| 35 | <xsl:with-param name="objID" select="a:PaymentProvider/a:ActorID"/>
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| 36 | </xsl:call-template>
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| 37 | </td>
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| 38 | <td>
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| 39 | <xsl:call-template name="actorName">
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| 40 | <xsl:with-param name="objID" select="a:Subscriber/a:ActorID"/>
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| 41 | </xsl:call-template>
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| 42 | </td>
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| 43 | <td>
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| 44 | <xsl:call-template name="actorName">
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| 45 | <xsl:with-param name="objID" select="a:Source/a:Actor/a:ActorID"/>
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| 46 | </xsl:call-template>
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| 47 | </td>
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| 48 | </tr>
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| 49 | </xsl:for-each>
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| 50 | </tbody>
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| 51 | </table>
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| 52 | </text>
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| 53 | <xsl:for-each select="/a:ContinuityOfCareRecord/a:Body/a:Payers/a:Payer">
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| 54 | <entry typeCode="DRIV">
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| 55 | <act classCode="ACT" moodCode="DEF">
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| 56 | <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17" assigningAuthorityName="IHE PCC"/>
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| 57 | <templateId root="2.16.840.1.113883.10.20.1.20" assigningAuthorityName="CCD"/>
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| 58 | <!-- Coverage entry template -->
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| 59 | <!-- <id> -->
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| 60 | <xsl:call-template name="ccdID">
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| 61 | <xsl:with-param name="ccrObjectID" select="a:CCRDataObjectID"/>
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| 62 | </xsl:call-template>
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| 63 | <code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
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| 64 | <statusCode code="completed"/>
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| 65 | <entryRelationship typeCode="COMP">
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| 66 | <act classCode="ACT" moodCode="EVN">
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| 67 | <templateId root="2.16.840.1.113883.3.88.11.83.5" assigningAuthorityName="HITSP C83"/>
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| 68 | <templateId root="2.16.840.1.113883.10.20.1.26" assigningAuthorityName="CCD"/>
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| 69 | <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.18" assigningAuthorityName="IHE PCC"/>
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| 70 | <!--Insurance provider template -->
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| 71 | <id>
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| 72 | <xsl:attribute name="root">
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| 73 | <xsl:value-of select="a:IDs[1]/a:ID"/>
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| 74 | </xsl:attribute>
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| 75 | <xsl:attribute name="extension">
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| 76 | <xsl:value-of select="a:IDs[1]/a:Type/a:Text"/>
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| 77 | </xsl:attribute>
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| 78 | </id>
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| 79 |
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| 80 | <!-- <code> -->
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| 81 | <xsl:call-template name="ccdCodedValue">
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| 82 | <xsl:with-param name="ccrCodedDescription" select="a:Description"/>
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| 83 | <xsl:with-param name="nodeName" select="'code'"/>
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| 84 | </xsl:call-template>
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| 85 |
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| 86 | <statusCode code="completed"/>
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| 87 |
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| 88 | <xsl:call-template name="ccdPerformer">
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| 89 | <xsl:with-param name="ccrActorReference" select="a:PaymentProvider"/>
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| 90 | </xsl:call-template>
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| 91 |
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| 92 | <participant typeCode="HLD">
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| 93 | <xsl:call-template name="ccdParticipantRoleActor">
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| 94 | <xsl:with-param name="ccrActorReference" select="a:Subscriber"/>
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| 95 | </xsl:call-template>
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| 96 | </participant>
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| 97 | </act>
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| 98 | </entryRelationship>
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| 99 | </act>
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| 100 | </entry>
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| 101 | </xsl:for-each>
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| 102 | </section>
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| 103 | </component>
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| 104 | </xsl:if>
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