@mindbill/react 0.18.0 → 0.20.0

package/dist/index.js

@@ -2,7 +2,7 @@
 
 // src/index.tsx
 import "@mindbill/embed";
-import { createElement, useEffect as useEffect5, useRef as useRef4 } from "react";
+import { createElement, useEffect as useEffect5, useRef as useRef5 } from "react";
 
 // src/appearance.ts
 var mindBillThemePresets = {
@@ -1043,9 +1043,123 @@ var NATIVE_THEME_OVERRIDE_STYLES = `
 .mb-native-combo-list{border-color:var(--mb-border);border-radius:var(--mb-control-radius);background:var(--mb-surface);box-shadow:var(--mb-shadow)}
 `;
 
-// src/bill-submission-form.tsx
-import { useEffect as useEffect2, useMemo as useMemo2, useState as useState2 } from "react";
+// src/bill-read-only-form.tsx
 import { jsx as jsx2, jsxs as jsxs2 } from "react/jsx-runtime";
+function money2(value) {
+  return new Intl.NumberFormat(void 0, { style: "currency", currency: "USD" }).format(value);
+}
+function date(value) {
+  if (!value) return "\u2014";
+  const parsed = /* @__PURE__ */ new Date(`${value.slice(0, 10)}T12:00:00`);
+  return Number.isNaN(parsed.getTime()) ? value : new Intl.DateTimeFormat(void 0, { dateStyle: "medium" }).format(parsed);
+}
+function Value({ label, children, wide = false }) {
+  return /* @__PURE__ */ jsxs2("div", { className: wide ? "mb-read-value is-wide" : "mb-read-value", children: [
+    /* @__PURE__ */ jsx2("dt", { children: label }),
+    /* @__PURE__ */ jsx2("dd", { children: children || "\u2014" })
+  ] });
+}
+function BillReadOnlyForm({ data, appearance, className, style, onOpenAttachment }) {
+  const { bill, patient, injury } = data;
+  const provider = bill.billingSnapshot?.billingProvider;
+  const clinician = bill.billingSnapshot?.renderingProvider;
+  const location = bill.billingSnapshot?.placeOfService;
+  const address = patient.address;
+  const patientAddress = [address?.line1, address?.city, address?.state, address?.postalCode].filter(Boolean).join(", ");
+  const locationAddress = location ? [location.street, location.city, location.state, location.zip].filter(Boolean).join(", ") : "";
+  return /* @__PURE__ */ jsxs2("section", { className: ["mb-readonly-bill", className].filter(Boolean).join(" "), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill details", children: [
+    /* @__PURE__ */ jsx2("style", { children: READ_ONLY_STYLES }),
+    /* @__PURE__ */ jsxs2("header", { className: "mb-readonly-heading", children: [
+      /* @__PURE__ */ jsxs2("div", { children: [
+        /* @__PURE__ */ jsx2("h2", { children: "Bill details" }),
+        /* @__PURE__ */ jsx2("p", { children: "Immutable snapshot submitted to the payer." })
+      ] }),
+      /* @__PURE__ */ jsx2("strong", { children: money2(bill.totalCharge) })
+    ] }),
+    /* @__PURE__ */ jsxs2("section", { className: "mb-read-card", children: [
+      /* @__PURE__ */ jsx2("h3", { children: "Patient" }),
+      /* @__PURE__ */ jsxs2("dl", { className: "mb-read-grid", children: [
+        /* @__PURE__ */ jsx2(Value, { label: "Name", children: patient.name || [patient.firstName, patient.middleName, patient.lastName].filter(Boolean).join(" ") }),
+        /* @__PURE__ */ jsx2(Value, { label: "Date of birth", children: date(patient.dob) }),
+        /* @__PURE__ */ jsx2(Value, { label: "Phone", children: patient.phone }),
+        /* @__PURE__ */ jsx2(Value, { label: "Address", wide: true, children: patientAddress })
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs2("section", { className: "mb-read-card", children: [
+      /* @__PURE__ */ jsx2("h3", { children: "Claim & injury" }),
+      /* @__PURE__ */ jsxs2("dl", { className: "mb-read-grid", children: [
+        /* @__PURE__ */ jsx2(Value, { label: "Claim number", children: injury.claimNumber }),
+        /* @__PURE__ */ jsx2(Value, { label: "WCAB / ADJ number", children: injury.adjNumber }),
+        /* @__PURE__ */ jsx2(Value, { label: "Claims administrator", children: injury.claimsAdminName }),
+        /* @__PURE__ */ jsx2(Value, { label: "Employer", children: injury.employer }),
+        /* @__PURE__ */ jsx2(Value, { label: "Date of injury", children: date(injury.doi) }),
+        /* @__PURE__ */ jsx2(Value, { label: "Date of service", children: bill.dosEnd ? `${date(bill.dos)} \u2013 ${date(bill.dosEnd)}` : date(bill.dos) }),
+        /* @__PURE__ */ jsx2(Value, { label: "Injury description", wide: true, children: injury.injuryDescription })
+      ] }),
+      injury.diagnosisCodes?.length ? /* @__PURE__ */ jsx2("div", { className: "mb-read-chips", "aria-label": "Diagnosis codes", children: injury.diagnosisCodes.map((code) => /* @__PURE__ */ jsx2("span", { children: code }, code)) }) : null
+    ] }),
+    /* @__PURE__ */ jsxs2("section", { className: "mb-read-card", children: [
+      /* @__PURE__ */ jsx2("h3", { children: "Providers & location" }),
+      /* @__PURE__ */ jsxs2("dl", { className: "mb-read-grid", children: [
+        /* @__PURE__ */ jsx2(Value, { label: "Billing provider", children: provider?.name }),
+        /* @__PURE__ */ jsx2(Value, { label: "Billing NPI", children: provider?.npi }),
+        /* @__PURE__ */ jsx2(Value, { label: "Rendering provider", children: clinician?.name }),
+        /* @__PURE__ */ jsx2(Value, { label: "Rendering NPI", children: clinician?.npi }),
+        /* @__PURE__ */ jsx2(Value, { label: "Specialty", children: clinician?.specialty }),
+        /* @__PURE__ */ jsx2(Value, { label: "Place of service", children: location?.name }),
+        /* @__PURE__ */ jsx2(Value, { label: "Service address", wide: true, children: locationAddress })
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs2("section", { className: "mb-read-card", children: [
+      /* @__PURE__ */ jsx2("h3", { children: "Service lines" }),
+      /* @__PURE__ */ jsxs2("div", { className: "mb-read-lines", role: "table", "aria-label": "Service lines", children: [
+        /* @__PURE__ */ jsxs2("div", { className: "mb-read-line-header", role: "row", children: [
+          /* @__PURE__ */ jsx2("span", { children: "Procedure" }),
+          /* @__PURE__ */ jsx2("span", { children: "Modifiers" }),
+          /* @__PURE__ */ jsx2("span", { children: "Units" }),
+          /* @__PURE__ */ jsx2("span", { children: "Charge" })
+        ] }),
+        bill.lineItems.map((line, index) => /* @__PURE__ */ jsxs2("div", { className: "mb-read-line", role: "row", children: [
+          /* @__PURE__ */ jsx2("strong", { children: line.code }),
+          /* @__PURE__ */ jsx2("div", { className: "mb-read-chips", children: line.modifiers.length ? line.modifiers.map((modifier) => /* @__PURE__ */ jsx2("span", { children: modifier }, modifier)) : "\u2014" }),
+          /* @__PURE__ */ jsx2("span", { children: line.units }),
+          /* @__PURE__ */ jsx2("strong", { children: money2(line.charge) })
+        ] }, line.id ?? `${line.code}-${index}`)),
+        /* @__PURE__ */ jsxs2("div", { className: "mb-read-total", children: [
+          /* @__PURE__ */ jsxs2("span", { children: [
+            "Paid ",
+            money2(bill.totalPaid)
+          ] }),
+          /* @__PURE__ */ jsxs2("strong", { children: [
+            "Balance ",
+            money2(bill.balanceDue)
+          ] })
+        ] })
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs2("section", { className: "mb-read-card", children: [
+      /* @__PURE__ */ jsx2("h3", { children: "Attachments" }),
+      bill.attachments.length ? /* @__PURE__ */ jsx2("ul", { className: "mb-read-documents", children: bill.attachments.map((attachment) => /* @__PURE__ */ jsxs2("li", { children: [
+        /* @__PURE__ */ jsxs2("div", { children: [
+          /* @__PURE__ */ jsx2("strong", { children: attachment.filename }),
+          /* @__PURE__ */ jsx2("span", { children: attachment.description || attachment.documentType.replace(/_/g, " ") })
+        ] }),
+        onOpenAttachment ? /* @__PURE__ */ jsx2("button", { type: "button", onClick: () => void onOpenAttachment(attachment), children: "View" }) : null
+      ] }, attachment.id)) }) : /* @__PURE__ */ jsx2("p", { className: "mb-read-empty", children: "No attachments." })
+    ] })
+  ] });
+}
+var READ_ONLY_STYLES = `
+.mb-readonly-bill{--mb-accent:#176c70;--mb-border:#d7e0df;--mb-surface:#fff;--mb-muted:#607176;color:var(--mb-text,#17282d);font:inherit;display:grid;gap:16px}.mb-readonly-heading{display:flex;align-items:flex-end;justify-content:space-between;gap:20px}.mb-readonly-heading h2,.mb-read-card h3{margin:0}.mb-readonly-heading p{margin:4px 0 0;color:var(--mb-muted)}.mb-readonly-heading>strong{font-size:1.35rem}.mb-read-card{background:var(--mb-surface);border:1px solid var(--mb-border);border-radius:var(--mb-radius,14px);padding:20px;box-shadow:0 1px 2px rgba(15,40,45,.04)}.mb-read-card h3{font-size:1.05rem;margin-bottom:16px}.mb-read-grid{display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:17px 28px;margin:0}.mb-read-value{min-width:0}.mb-read-value.is-wide{grid-column:1/-1}.mb-read-value dt{color:var(--mb-muted);font-size:.75rem;font-weight:700;letter-spacing:.07em;text-transform:uppercase}.mb-read-value dd{font-weight:600;margin:5px 0 0;overflow-wrap:anywhere}.mb-read-chips{display:flex;flex-wrap:wrap;gap:6px;margin-top:16px}.mb-read-chips span{border:1px solid var(--mb-border);border-radius:999px;padding:3px 9px;font-size:.82rem;background:#f7f9f8}.mb-read-lines{border:1px solid var(--mb-border);border-radius:10px;overflow:hidden}.mb-read-line-header,.mb-read-line{display:grid;grid-template-columns:1.2fr 1.5fr .45fr .7fr;gap:16px;align-items:center;padding:12px 14px}.mb-read-line-header{background:#f6f8f7;color:var(--mb-muted);font-size:.75rem;font-weight:700;text-transform:uppercase}.mb-read-line{border-top:1px solid var(--mb-border)}.mb-read-line .mb-read-chips{margin:0}.mb-read-line>span:last-child,.mb-read-line>strong:last-child{text-align:right}.mb-read-total{display:flex;justify-content:flex-end;gap:24px;border-top:1px solid var(--mb-border);padding:13px 14px}.mb-read-documents{list-style:none;padding:0;margin:0;display:grid}.mb-read-documents li{display:flex;align-items:center;justify-content:space-between;gap:16px;padding:13px 0;border-top:1px solid var(--mb-border)}.mb-read-documents li:first-child{border-top:0;padding-top:0}.mb-read-documents li:last-child{padding-bottom:0}.mb-read-documents div{display:grid;gap:3px;min-width:0}.mb-read-documents strong{overflow-wrap:anywhere}.mb-read-documents span,.mb-read-empty{color:var(--mb-muted)}.mb-read-documents button{border:1px solid var(--mb-border);border-radius:8px;background:transparent;color:inherit;padding:8px 13px;font:inherit;font-weight:650;cursor:pointer}.mb-read-documents button:hover{border-color:var(--mb-accent);color:var(--mb-accent)}
+@media(max-width:700px){.mb-readonly-heading{align-items:flex-start}.mb-read-grid{grid-template-columns:1fr}.mb-read-value.is-wide{grid-column:auto}.mb-read-card{padding:16px}.mb-read-line-header{display:none}.mb-read-line{grid-template-columns:1fr auto;gap:8px}.mb-read-line>*:nth-child(2){grid-column:1/-1}.mb-read-total{justify-content:space-between}.mb-readonly-heading>strong{font-size:1.05rem}}
+`;
+
+// src/bill-submission-form.tsx
+import { useCallback, useEffect as useEffect2, useMemo as useMemo2, useRef as useRef2, useState as useState2 } from "react";
+import {
+  createBillReferenceClient
+} from "@mindbill/browser";
+import { Fragment as Fragment2, jsx as jsx3, jsxs as jsxs3 } from "react/jsx-runtime";
 var BILL_SUBMISSION_DOCUMENT_TYPES = [
   "final_report",
   "proof_of_service",
@@ -1060,44 +1174,36 @@ var BILL_SUBMISSION_DOCUMENT_TYPES = [
 var BILL_SUBMISSION_REQUIRED_FIELDS = [
   "patient.firstName",
   "patient.lastName",
+  "patient.dateOfBirth",
   "patient.address.line1",
   "patient.address.city",
   "patient.address.state",
   "patient.address.postalCode",
   "claim.claimNumber",
+  "claim.claimsAdministrator",
   "service.date",
   "serviceLines[].code",
   "serviceLines[].units"
 ];
-function validateBillSubmission(bill) {
-  const errors = {};
-  const required = (path, value) => {
-    if (typeof value !== "string" || !value.trim()) errors[path] = "Required";
-  };
-  required("patient.firstName", bill.patient.firstName);
-  required("patient.lastName", bill.patient.lastName);
-  required("patient.address.line1", bill.patient.address.line1);
-  required("patient.address.city", bill.patient.address.city);
-  required("patient.address.state", bill.patient.address.state);
-  required("patient.address.postalCode", bill.patient.address.postalCode);
-  required("claim.claimNumber", bill.claim.claimNumber);
-  required("service.date", bill.service.date);
-  if (bill.patient.address.state.trim().length !== 2)
-    errors["patient.address.state"] = "Use a 2-letter state code";
-  if (!bill.serviceLines.length) errors.serviceLines = "Add at least one service line";
-  bill.serviceLines.forEach((line, index) => {
-    required(`serviceLines.${index}.code`, line.code);
-    if (!Number.isInteger(line.units) || (line.units ?? 0) < 1)
-      errors[`serviceLines.${index}.units`] = "Enter at least 1 unit";
-    if (bill.billingMode === "professional" && (!Number.isFinite(line.charge) || (line.charge ?? 0) < 0))
-      errors[`serviceLines.${index}.charge`] = "Enter the billed charge";
-  });
-  return { valid: Object.keys(errors).length === 0, fieldErrors: errors };
-}
-var MAX_PDF_BYTES = 25 * 1024 * 1024;
-var MAX_UPLOAD_BYTES = 100 * 1024 * 1024;
-var MAX_DOCUMENTS = 25;
-var EMPTY_ATTACHMENTS = [];
+var PROCEDURES2 = [
+  { code: "ML200", description: "Missed appointment for a medical-legal evaluation" },
+  { code: "ML201", description: "Comprehensive medical-legal evaluation" },
+  { code: "ML202", description: "Follow-up medical-legal evaluation" },
+  { code: "ML203", description: "Supplemental medical-legal evaluation" },
+  { code: "ML204", description: "Medical-legal testimony" },
+  { code: "ML205", description: "Review of sub rosa recordings" },
+  { code: "MLPRR", description: "Medical-legal record review" }
+];
+var MODIFIERS2 = [
+  { code: "92", description: "Primary Treating Physician evaluation" },
+  { code: "93", description: "Interpreter required" },
+  { code: "94", description: "Agreed Medical Evaluator" },
+  { code: "95", description: "Qualified Medical Evaluator" },
+  { code: "96", description: "Psychiatric/psychological evaluation" },
+  { code: "97", description: "Toxicology evaluation" },
+  { code: "98", description: "Oncology evaluation" },
+  { code: "59", description: "Distinct procedural service" }
+];
 var documentLabels = {
   final_report: "Final report",
   proof_of_service: "Proof of service",
@@ -1109,157 +1215,189 @@ var documentLabels = {
   appeal: "Appeal",
   other: "Other"
 };
+var MAX_PDF_BYTES = 25 * 1024 * 1024;
+var MAX_UPLOAD_BYTES = 100 * 1024 * 1024;
+var MAX_DOCUMENTS = 25;
+var EMPTY_ATTACHMENTS = [];
+function blankLine() {
+  return { code: "", modifiers: [], units: 1 };
+}
+function lineHasContent(line) {
+  return Boolean(line.code.trim() || line.modifiers?.length || line.charge != null);
+}
+function ensureTrailingBillSubmissionLine(lines) {
+  const normalized = lines.length ? lines.map((line) => ({ ...line, modifiers: [...line.modifiers ?? []], units: line.units ?? 1 })) : [];
+  while (normalized.length > 1 && !lineHasContent(normalized.at(-1)) && !lineHasContent(normalized.at(-2))) normalized.pop();
+  if (!normalized.length || lineHasContent(normalized.at(-1))) normalized.push(blankLine());
+  return normalized;
+}
+function parseBillSubmissionDate(value) {
+  const trimmed = value.trim();
+  const iso = /^(\d{4})-(\d{2})-(\d{2})$/.exec(trimmed);
+  const us = /^(\d{1,2})[/-](\d{1,2})[/-](\d{4})$/.exec(trimmed);
+  const digits = /^(\d{2})(\d{2})(\d{4})$/.exec(trimmed.replace(/\D/g, ""));
+  const match = iso ? [iso[2], iso[3], iso[1]] : us ? [us[1], us[2], us[3]] : digits ? [digits[1], digits[2], digits[3]] : null;
+  if (!match) return void 0;
+  const month = Number(match[0]);
+  const day = Number(match[1]);
+  const year = Number(match[2]);
+  const date2 = new Date(Date.UTC(year, month - 1, day));
+  if (date2.getUTCFullYear() !== year || date2.getUTCMonth() !== month - 1 || date2.getUTCDate() !== day) return void 0;
+  return `${String(year).padStart(4, "0")}-${String(month).padStart(2, "0")}-${String(day).padStart(2, "0")}`;
+}
+function formatBillSubmissionDate(value) {
+  const parsed = value ? parseBillSubmissionDate(value) : void 0;
+  if (!parsed) return "";
+  const [year, month, day] = parsed.split("-");
+  return `${month}/${day}/${year}`;
+}
+function evaluationModifier(type, code) {
+  if (!/^ML(?:200|201|202|203|PRR)$/.test(code.toUpperCase())) return void 0;
+  if (type === "ame") return code.toUpperCase() === "ML200" || code.toUpperCase() === "MLPRR" ? void 0 : "94";
+  if (type === "psych_qme") return code.toUpperCase() === "ML200" ? "95" : code.toUpperCase() === "MLPRR" ? void 0 : "96";
+  return "95";
+}
+function applyBillSubmissionEvaluationModifiers(lines, type) {
+  return lines.map((line) => {
+    const auto = evaluationModifier(type, line.code);
+    const modifiers = (line.modifiers ?? []).filter((item) => !["94", "95", "96"].includes(item.replace(/^-/, "")));
+    return { ...line, modifiers: auto ? [auto, ...modifiers] : modifiers };
+  });
+}
+function submittedLines(lines) {
+  return lines.filter(lineHasContent).map((line) => ({ ...line, code: line.code.trim(), modifiers: [...line.modifiers ?? []] }));
+}
 function cloneBill(bill) {
   return {
     ...bill,
     patient: { ...bill.patient, address: { ...bill.patient.address } },
-    claim: {
-      ...bill.claim,
-      ...bill.claim.claimsAdministrator ? { claimsAdministrator: { ...bill.claim.claimsAdministrator } } : {}
-    },
+    claim: { ...bill.claim, ...bill.claim.claimsAdministrator ? { claimsAdministrator: { ...bill.claim.claimsAdministrator } } : {} },
     service: { ...bill.service },
-    ...bill.billingProvider ? {
-      billingProvider: {
-        ...bill.billingProvider,
-        ...bill.billingProvider.address ? { address: { ...bill.billingProvider.address } } : {}
-      }
-    } : {},
+    ...bill.billingProvider ? { billingProvider: { ...bill.billingProvider, ...bill.billingProvider.address ? { address: { ...bill.billingProvider.address } } : {} } } : {},
     ...bill.renderingProvider ? { renderingProvider: { ...bill.renderingProvider } } : {},
-    ...bill.serviceLocation ? {
-      serviceLocation: {
-        ...bill.serviceLocation,
-        ...bill.serviceLocation.address ? { address: { ...bill.serviceLocation.address } } : {}
-      }
-    } : {},
+    ...bill.serviceLocation ? { serviceLocation: { ...bill.serviceLocation, ...bill.serviceLocation.address ? { address: { ...bill.serviceLocation.address } } : {} } } : {},
     diagnoses: [...bill.diagnoses ?? []],
-    serviceLines: bill.serviceLines.length ? bill.serviceLines.map((line) => ({
-      ...line,
-      modifiers: [...line.modifiers ?? []],
-      diagnosisPointers: [...line.diagnosisPointers ?? []],
-      units: line.units ?? 1
-    })) : [{ code: "", modifiers: [], units: 1 }]
+    serviceLines: ensureTrailingBillSubmissionLine(bill.serviceLines)
   };
 }
-var styles = {
-  root: {
-    display: "grid",
-    gap: 18,
-    color: "var(--mb-text)",
-    fontFamily: "var(--mb-font)"
-  },
-  heading: {
-    display: "flex",
-    alignItems: "start",
-    justifyContent: "space-between",
-    gap: 20
-  },
-  title: { margin: 0, fontSize: 22, lineHeight: 1.2 },
-  copy: { margin: "5px 0 0", color: "var(--mb-muted)", fontSize: 14 },
-  requiredNote: { color: "var(--mb-muted)", fontSize: 13, whiteSpace: "nowrap" },
-  section: {
-    minWidth: 0,
-    margin: 0,
-    padding: 20,
-    border: "1px solid var(--mb-border)",
-    borderRadius: "var(--mb-radius)",
-    background: "var(--mb-surface)",
-    boxShadow: "var(--mb-shadow)"
-  },
-  legend: { padding: "0 8px", fontWeight: 700, fontSize: 15 },
-  grid: {
-    display: "grid",
-    gridTemplateColumns: "repeat(auto-fit, minmax(min(100%, 210px), 1fr))",
-    gap: 14
-  },
-  field: { display: "grid", alignContent: "start", gap: 6, minWidth: 0 },
-  label: { color: "var(--mb-muted)", fontSize: 12, fontWeight: 700 },
-  input: {
-    boxSizing: "border-box",
-    width: "100%",
-    minHeight: 40,
-    padding: "9px 11px",
-    border: "1px solid var(--mb-border)",
-    borderRadius: "var(--mb-control-radius)",
-    background: "var(--mb-input)",
-    color: "var(--mb-text)",
-    font: "inherit"
-  },
-  tableWrap: { overflowX: "auto" },
-  table: { width: "100%", minWidth: 610, borderCollapse: "collapse" },
-  th: {
-    padding: "0 8px 8px",
-    color: "var(--mb-muted)",
-    fontSize: 12,
-    textAlign: "left"
-  },
-  td: { padding: "7px 8px", borderTop: "1px solid var(--mb-border)" },
-  secondaryButton: {
-    minHeight: 36,
-    padding: "7px 11px",
-    border: "1px solid var(--mb-border)",
-    borderRadius: "var(--mb-control-radius)",
-    background: "var(--mb-surface)",
-    color: "var(--mb-text)",
-    font: "inherit",
-    fontWeight: 650,
-    cursor: "pointer"
-  },
-  attachment: {
-    display: "flex",
-    alignItems: "center",
-    justifyContent: "space-between",
-    gap: 12,
-    padding: "11px 0",
-    borderBottom: "1px solid var(--mb-border)"
-  },
-  attachmentName: { display: "grid", gap: 2, minWidth: 0, flex: 1 },
-  attachmentMeta: { color: "var(--mb-muted)", fontSize: 12 },
-  error: {
-    padding: "11px 13px",
-    borderRadius: "var(--mb-control-radius)",
-    background: "color-mix(in srgb, var(--mb-danger) 10%, transparent)",
-    color: "var(--mb-danger)",
-    fontSize: 13
-  },
-  actions: { display: "flex", justifyContent: "flex-end" },
-  submit: {
-    minWidth: 150,
-    minHeight: 42,
-    padding: "10px 20px",
-    border: 0,
-    borderRadius: "var(--mb-control-radius)",
-    background: "var(--mb-accent)",
-    color: "var(--mb-accent-contrast)",
-    font: "inherit",
-    fontWeight: 750,
-    cursor: "pointer"
+function validateBillSubmission(bill) {
+  const errors = {};
+  const required = (path, value) => {
+    if (typeof value !== "string" || !value.trim()) errors[path] = "Required";
+  };
+  required("patient.firstName", bill.patient.firstName);
+  required("patient.lastName", bill.patient.lastName);
+  required("patient.dateOfBirth", bill.patient.dateOfBirth);
+  required("patient.address.line1", bill.patient.address.line1);
+  required("patient.address.city", bill.patient.address.city);
+  required("patient.address.state", bill.patient.address.state);
+  required("patient.address.postalCode", bill.patient.address.postalCode);
+  required("claim.claimNumber", bill.claim.claimNumber);
+  required("claim.claimsAdministrator", bill.claim.claimsAdministrator?.name);
+  required("service.date", bill.service.date);
+  if (bill.claim.claimsAdministrator?.name && !bill.claim.claimsAdministrator.id) {
+    errors["claim.claimsAdministrator"] = "Select a claims administrator from the payer directory.";
   }
-};
+  if (bill.patient.dateOfBirth && !parseBillSubmissionDate(bill.patient.dateOfBirth)) errors["patient.dateOfBirth"] = "Use MM/DD/YYYY";
+  if (bill.patient.address.state.trim().length !== 2) errors["patient.address.state"] = "Use a 2-letter state code";
+  const lines = submittedLines(bill.serviceLines);
+  if (!lines.length) errors.serviceLines = "Add at least one service line";
+  lines.forEach((line, index) => {
+    required(`serviceLines.${index}.code`, line.code);
+    if (!Number.isInteger(line.units) || (line.units ?? 0) < 1) errors[`serviceLines.${index}.units`] = "Enter at least 1 unit";
+    if (bill.billingMode === "professional" && (!Number.isFinite(line.charge) || (line.charge ?? 0) < 0)) errors[`serviceLines.${index}.charge`] = "Enter the billed charge";
+  });
+  return { valid: Object.keys(errors).length === 0, fieldErrors: errors };
+}
+var css = `
+.mbsf{display:grid;gap:20px;color:var(--mb-text);font-family:var(--mb-font);font-size:15px}.mbsf *{box-sizing:border-box}
+.mbsf-head,.mbsf-section-head,.mbsf-attach-row,.mbsf-actions{display:flex;align-items:center;justify-content:space-between;gap:16px}.mbsf-title{margin:0;font-size:24px}.mbsf-copy,.mbsf-help{color:var(--mb-muted);margin:5px 0 0}.mbsf-required{font-size:13px;color:var(--mb-muted);white-space:nowrap}.mbsf-star,.mbsf-error{color:var(--mb-danger)}
+.mbsf-card{min-width:0;margin:0;padding:24px;border:1px solid var(--mb-border);border-radius:var(--mb-radius);background:var(--mb-surface);box-shadow:var(--mb-shadow)}.mbsf-legend{padding:0 10px;font-size:18px;font-weight:760}.mbsf-grid{display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:18px 24px}.mbsf-span{grid-column:1/-1}.mbsf-field{display:grid;align-content:start;gap:7px;min-width:0}.mbsf-label{font-weight:680}.mbsf-input,.mbsf-select{width:100%;min-height:46px;padding:10px 12px;border:1px solid var(--mb-border);border-radius:var(--mb-control-radius);background:var(--mb-input);color:var(--mb-text);font:inherit}.mbsf-input:focus,.mbsf-select:focus{outline:3px solid color-mix(in srgb,var(--mb-accent) 22%,transparent);border-color:var(--mb-accent)}
+.mbsf-combo{position:relative}.mbsf-menu{position:absolute;z-index:20;top:calc(100% + 5px);left:0;right:0;max-height:300px;overflow:auto;padding:7px;border:1px solid var(--mb-border);border-radius:12px;background:var(--mb-surface);box-shadow:0 14px 35px rgba(17,38,49,.16)}.mbsf-option{display:grid;width:100%;gap:2px;padding:10px;border:0;border-radius:8px;background:transparent;color:var(--mb-text);font:inherit;text-align:left;cursor:pointer}.mbsf-option:hover,.mbsf-option:focus{background:color-mix(in srgb,var(--mb-accent) 9%,var(--mb-surface))}.mbsf-option small{color:var(--mb-muted)}
+.mbsf-chips{display:flex;flex-wrap:wrap;gap:7px;margin-bottom:8px}.mbsf-chip{display:inline-flex;align-items:center;gap:7px;padding:5px 9px;border:1px solid var(--mb-border);border-radius:999px;background:var(--mb-input)}.mbsf-chip button{border:0;background:transparent;color:var(--mb-muted);cursor:pointer;font:inherit}
+.mbsf-segments{display:grid;grid-template-columns:repeat(3,1fr);border:1px solid var(--mb-border);border-radius:var(--mb-control-radius);overflow:hidden}.mbsf-segment{min-height:44px;border:0;border-right:1px solid var(--mb-border);background:var(--mb-input);color:var(--mb-text);font:inherit;font-weight:700;cursor:pointer}.mbsf-segment:last-child{border-right:0}.mbsf-segment[aria-pressed=true]{background:var(--mb-accent);color:var(--mb-accent-contrast)}
+.mbsf-lines{margin-top:18px;border:1px solid var(--mb-border);border-radius:var(--mb-control-radius);overflow:visible}.mbsf-line-head,.mbsf-line{display:grid;grid-template-columns:minmax(190px,1.05fr) minmax(220px,1.5fr) 100px 120px 42px;gap:12px;align-items:start;padding:12px}.mbsf-line-head{color:var(--mb-muted);font-size:13px;font-weight:700;border-bottom:1px solid var(--mb-border)}.mbsf-line{border-bottom:1px solid var(--mb-border)}.mbsf-line:last-child{border-bottom:0}.mbsf-money{padding-top:12px;text-align:right;font-variant-numeric:tabular-nums}.mbsf-total{display:flex;justify-content:flex-end;gap:45px;padding:16px 56px 16px 16px;font-size:17px;font-weight:760}
+.mbsf-icon-btn{width:40px;height:42px;border:0;background:transparent;color:var(--mb-text);font-size:22px;cursor:pointer}.mbsf-secondary{min-height:40px;padding:8px 14px;border:1px solid var(--mb-border);border-radius:var(--mb-control-radius);background:var(--mb-surface);color:var(--mb-text);font:inherit;font-weight:680;cursor:pointer}.mbsf-attach-list{display:grid;gap:10px;margin-bottom:18px}.mbsf-attach-row{padding:14px;border:1px solid var(--mb-border);border-radius:var(--mb-control-radius)}.mbsf-attach-row[data-auto=true]{border-color:color-mix(in srgb,#159447 45%,var(--mb-border));background:color-mix(in srgb,#159447 5%,var(--mb-surface))}.mbsf-file{min-width:0}.mbsf-file strong{overflow-wrap:anywhere}.mbsf-badge{display:inline-block;margin-left:8px;padding:2px 7px;border:1px solid var(--mb-border);border-radius:7px;color:var(--mb-muted);font-size:12px;font-weight:600}.mbsf-drop{display:grid;place-items:center;min-height:180px;padding:24px;border:2px dashed color-mix(in srgb,var(--mb-muted) 55%,transparent);border-radius:var(--mb-control-radius);background:color-mix(in srgb,var(--mb-accent) 3%,var(--mb-surface));text-align:center;cursor:pointer}.mbsf-drop[data-active=true]{border-color:var(--mb-accent);background:color-mix(in srgb,var(--mb-accent) 10%,var(--mb-surface))}.mbsf-alert{padding:12px 14px;border-radius:var(--mb-control-radius);background:color-mix(in srgb,var(--mb-danger) 10%,transparent);color:var(--mb-danger)}.mbsf-actions{justify-content:flex-end}.mbsf-submit{min-width:180px;min-height:48px;padding:11px 24px;border:0;border-radius:var(--mb-control-radius);background:var(--mb-accent);color:var(--mb-accent-contrast);font:inherit;font-weight:780;cursor:pointer}
+@media(max-width:820px){.mbsf-grid{grid-template-columns:1fr}.mbsf-span{grid-column:auto}.mbsf-card{padding:18px}.mbsf-line-head{display:none}.mbsf-line{grid-template-columns:1fr 1fr}.mbsf-line>*:nth-child(1),.mbsf-line>*:nth-child(2){grid-column:1/-1}.mbsf-money{text-align:left}.mbsf-line .mbsf-icon-btn{justify-self:end}.mbsf-total{padding-right:18px}.mbsf-head{align-items:flex-start}.mbsf-segments{grid-template-columns:1fr}.mbsf-segment{border-right:0;border-bottom:1px solid var(--mb-border)}.mbsf-segment:last-child{border-bottom:0}}
+`;
 function RequiredMark() {
-  return /* @__PURE__ */ jsx2("span", { className: "required-mark", style: { color: "var(--mb-danger)" }, children: " *" });
+  return /* @__PURE__ */ jsx3("span", { className: "mbsf-star", children: " *" });
 }
-function Field2({
-  label,
-  required,
-  error,
-  children
-}) {
-  return /* @__PURE__ */ jsxs2("label", { style: styles.field, children: [
-    /* @__PURE__ */ jsxs2("span", { style: styles.label, children: [
+function Field2({ label, required, error, span, children }) {
+  return /* @__PURE__ */ jsxs3("label", { className: `mbsf-field${span ? " mbsf-span" : ""}`, children: [
+    /* @__PURE__ */ jsxs3("span", { className: "mbsf-label", children: [
       label,
-      required ? /* @__PURE__ */ jsx2(RequiredMark, {}) : null
+      required ? /* @__PURE__ */ jsx3(RequiredMark, {}) : null
     ] }),
     children,
-    error ? /* @__PURE__ */ jsx2("span", { style: { color: "var(--mb-danger)", fontSize: 12 }, children: error }) : null
+    error ? /* @__PURE__ */ jsx3("small", { className: "mbsf-error", children: error }) : null
+  ] });
+}
+function TextDateInput({ value, onChange, disabled, required, ariaLabel }) {
+  const [display, setDisplay] = useState2(() => formatBillSubmissionDate(value));
+  const [invalid, setInvalid] = useState2(false);
+  useEffect2(() => {
+    setDisplay(formatBillSubmissionDate(value));
+    setInvalid(false);
+  }, [value]);
+  return /* @__PURE__ */ jsxs3(Fragment2, { children: [
+    /* @__PURE__ */ jsx3("input", { className: "mbsf-input", type: "text", inputMode: "numeric", autoComplete: "off", placeholder: "MM/DD/YYYY", "aria-label": ariaLabel, "aria-invalid": invalid, required, disabled, value: display, onChange: (event) => {
+      const next = event.target.value;
+      const parsed = parseBillSubmissionDate(next);
+      setDisplay(next);
+      setInvalid(Boolean(next && !parsed));
+      if (!next.trim()) onChange("");
+      else if (parsed) onChange(parsed);
+    }, onBlur: () => setInvalid(Boolean(display && !parseBillSubmissionDate(display))) }),
+    invalid ? /* @__PURE__ */ jsx3("small", { className: "mbsf-error", children: "Use MM/DD/YYYY" }) : null
+  ] });
+}
+function ComboBox({ value, placeholder, options, disabled, loading, onQuery, onSelect, ariaLabel }) {
+  const [open, setOpen] = useState2(false);
+  const [query, setQuery] = useState2("");
+  const visible = useMemo2(() => {
+    const q = query.trim().toLowerCase();
+    return q ? options.filter((option) => `${option.id} ${option.label} ${option.detail ?? ""}`.toLowerCase().includes(q)) : options;
+  }, [options, query]);
+  return /* @__PURE__ */ jsxs3("div", { className: "mbsf-combo", children: [
+    /* @__PURE__ */ jsx3("input", { className: "mbsf-input", role: "combobox", "aria-label": ariaLabel, "aria-expanded": open, autoComplete: "off", disabled, placeholder, value: open ? query : value, onFocus: () => {
+      setOpen(true);
+      setQuery("");
+      onQuery?.("");
+    }, onChange: (event) => {
+      setOpen(true);
+      setQuery(event.target.value);
+      onQuery?.(event.target.value);
+    }, onBlur: () => setTimeout(() => setOpen(false), 120) }),
+    open ? /* @__PURE__ */ jsx3("div", { className: "mbsf-menu", role: "listbox", children: loading ? /* @__PURE__ */ jsx3("div", { className: "mbsf-option", children: "Searching\u2026" }) : visible.length ? visible.map((option) => /* @__PURE__ */ jsxs3("button", { className: "mbsf-option", type: "button", role: "option", onMouseDown: (event) => event.preventDefault(), onClick: () => {
+      onSelect(option);
+      setOpen(false);
+      setQuery("");
+    }, children: [
+      /* @__PURE__ */ jsx3("strong", { children: option.label }),
+      option.detail ? /* @__PURE__ */ jsx3("small", { children: option.detail }) : null
+    ] }, option.id)) : /* @__PURE__ */ jsx3("div", { className: "mbsf-option", children: "No matches" }) }) : null
   ] });
 }
-function inputValue(value) {
-  return value ?? "";
+function mergeOptions(defaults, supplied) {
+  const map = new Map(defaults.map((item) => [item.code.toUpperCase(), item]));
+  supplied?.forEach((item) => map.set(item.code.toUpperCase(), item));
+  return [...map.values()];
 }
 function BillSubmissionForm({
   initialBill,
   attachments = EMPTY_ATTACHMENTS,
   onSubmit,
+  getSession,
+  sessionEndpoint,
+  apiBaseUrl,
+  fetch: fetchOverride,
+  onSearchClaimsAdministrators,
+  diagnosisOptions = [],
+  onSearchDiagnoses,
+  onLookupPostalCode,
+  procedureOptions,
+  modifierOptions,
   appearance,
   className = "bill-submission-form",
   style,
@@ -1269,264 +1407,296 @@ function BillSubmissionForm({
   description = "Review the bill details, add attachments, and submit."
 }) {
   const [bill, setBill] = useState2(() => cloneBill(initialBill));
-  const [selectedIds, setSelectedIds] = useState2(
-    () => attachments.filter((item) => item.selected !== false).map((item) => item.id)
-  );
+  const [selectedIds, setSelectedIds] = useState2(() => attachments.filter((item) => item.selected !== false || item.autoAttached).map((item) => item.id));
   const [uploads, setUploads] = useState2([]);
   const [errors, setErrors] = useState2({});
   const [formError, setFormError] = useState2(null);
   const [submitting, setSubmitting] = useState2(false);
+  const [payerResults, setPayerResults] = useState2([]);
+  const [payerLoading, setPayerLoading] = useState2(false);
+  const [diagnosisResults, setDiagnosisResults] = useState2(diagnosisOptions);
+  const [diagnosisLoading, setDiagnosisLoading] = useState2(false);
+  const [postalStatus, setPostalStatus] = useState2(null);
+  const [dragActive, setDragActive] = useState2(false);
+  const fileInput = useRef2(null);
+  const procedures = useMemo2(() => mergeOptions(PROCEDURES2, procedureOptions), [procedureOptions]);
+  const modifiers = useMemo2(() => mergeOptions(MODIFIERS2, modifierOptions), [modifierOptions]);
+  const [evaluationType, setEvaluationType] = useState2(() => initialBill.renderingProvider?.isAme ? "ame" : initialBill.renderingProvider?.specialty?.toLowerCase().includes("psych") ? "psych_qme" : "qme");
+  const referenceClient = useMemo2(() => getSession ? createBillReferenceClient({ getSession, sessionEndpoint, apiBaseUrl, fetch: fetchOverride }) : null, [getSession, sessionEndpoint, apiBaseUrl, fetchOverride]);
+  const locked = disabled || submitting;
   useEffect2(() => {
     setBill(cloneBill(initialBill));
-    setSelectedIds(
-      attachments.filter((item) => item.selected !== false).map((item) => item.id)
-    );
+    setSelectedIds(attachments.filter((item) => item.selected !== false || item.autoAttached).map((item) => item.id));
     setUploads([]);
     setErrors({});
     setFormError(null);
   }, [initialBill, attachments]);
-  const diagnoses = useMemo2(() => (bill.diagnoses ?? []).join(", "), [bill.diagnoses]);
-  const locked = disabled || submitting;
-  const setPatient = (patch) => setBill((current) => ({ ...current, patient: { ...current.patient, ...patch } }));
-  const setOptionalPatient = (key, value) => setBill((current) => {
-    const patient = { ...current.patient };
-    if (value) patient[key] = value;
-    else delete patient[key];
-    return { ...current, patient };
-  });
-  const setAddress = (patch) => setBill((current) => ({
-    ...current,
-    patient: {
-      ...current.patient,
-      address: { ...current.patient.address, ...patch }
-    }
-  }));
-  const setClaim = (patch) => setBill((current) => ({ ...current, claim: { ...current.claim, ...patch } }));
-  const setOptionalClaim = (key, value) => setBill((current) => {
-    const claim = { ...current.claim };
-    if (value) claim[key] = value;
-    else delete claim[key];
-    return { ...current, claim };
-  });
-  const setService = (patch) => setBill((current) => ({ ...current, service: { ...current.service, ...patch } }));
-  const setLine = (index, patch) => setBill((current) => ({
-    ...current,
-    serviceLines: current.serviceLines.map(
-      (line, lineIndex) => lineIndex === index ? { ...line, ...patch } : line
-    )
-  }));
-  const setOptionalLineNumber = (index, key, value) => setBill((current) => ({
-    ...current,
-    serviceLines: current.serviceLines.map((line, lineIndex) => {
-      if (lineIndex !== index) return line;
-      const next = { ...line };
-      if (value === "") delete next[key];
-      else next[key] = Number(value);
-      return next;
-    })
-  }));
-  const textInput = (value, onChange, options) => /* @__PURE__ */ jsx2(
-    "input",
-    {
-      style: styles.input,
-      value: inputValue(value),
-      disabled: locked,
-      onChange: (event) => onChange(event.target.value),
-      ...options
+  const addFiles = useCallback((fileList) => {
+    const files = Array.from(fileList);
+    if (!files.length) return;
+    setFormError(null);
+    const invalid = files.find((file) => file.type !== "application/pdf" && !file.name.toLowerCase().endsWith(".pdf"));
+    if (invalid) return setFormError(`${invalid.name} is not a PDF.`);
+    const oversized = files.find((file) => file.size > MAX_PDF_BYTES);
+    if (oversized) return setFormError(`${oversized.name} is larger than 25 MB.`);
+    const nextBytes = [...uploads.map((item) => item.file), ...files].reduce((sum, file) => sum + file.size, 0);
+    if (nextBytes > MAX_UPLOAD_BYTES) return setFormError("Attachments exceed the 100 MB upload limit.");
+    if (selectedIds.length + uploads.length + files.length > MAX_DOCUMENTS) return setFormError(`A bill can include at most ${MAX_DOCUMENTS} attachments.`);
+    setUploads((current) => [...current, ...files.map((file) => ({ file, documentType: "other" }))]);
+  }, [selectedIds.length, uploads]);
+  useEffect2(() => {
+    const over = (event) => {
+      if (event.dataTransfer?.types.includes("Files")) {
+        event.preventDefault();
+        setDragActive(true);
+      }
+    };
+    const leave = (event) => {
+      if (!event.relatedTarget) setDragActive(false);
+    };
+    const drop = (event) => {
+      if (event.dataTransfer?.files.length) {
+        event.preventDefault();
+        setDragActive(false);
+        addFiles(event.dataTransfer.files);
+      }
+    };
+    window.addEventListener("dragover", over);
+    window.addEventListener("dragleave", leave);
+    window.addEventListener("drop", drop);
+    return () => {
+      window.removeEventListener("dragover", over);
+      window.removeEventListener("dragleave", leave);
+      window.removeEventListener("drop", drop);
+    };
+  }, [addFiles]);
+  const setAddress = (patch) => setBill((current) => ({ ...current, patient: { ...current.patient, address: { ...current.patient.address, ...patch } } }));
+  const setLine = (index, patch) => setBill((current) => ({ ...current, serviceLines: ensureTrailingBillSubmissionLine(current.serviceLines.map((line, lineIndex) => lineIndex === index ? { ...line, ...patch } : line)) }));
+  const text = (value, onChange, options = {}) => /* @__PURE__ */ jsx3("input", { className: "mbsf-input", disabled: locked, value: value ?? "", onChange: (event) => onChange(event.target.value), ...options });
+  const searchPayers = (query) => {
+    if (query.trim().length < 2) return;
+    setPayerLoading(true);
+    const search = onSearchClaimsAdministrators ?? referenceClient?.searchClaimsAdministrators;
+    if (!search) {
+      setPayerLoading(false);
+      return;
     }
-  );
+    void search(query, bill.claim.claimNumber).then(setPayerResults).catch((caught) => setFormError(caught instanceof Error ? caught.message : "Claims administrator search is unavailable.")).finally(() => setPayerLoading(false));
+  };
+  const searchDiagnoses = (query) => {
+    if (!onSearchDiagnoses) return;
+    setDiagnosisLoading(true);
+    void onSearchDiagnoses(query).then(setDiagnosisResults).catch(() => setDiagnosisResults([])).finally(() => setDiagnosisLoading(false));
+  };
+  const updatePostalCode = (postalCode) => {
+    setAddress({ postalCode });
+    setPostalStatus(null);
+    if (!onLookupPostalCode || !/^\d{5}$/.test(postalCode)) return;
+    void onLookupPostalCode(postalCode).then((place) => {
+      if (!place) return setPostalStatus("ZIP not found");
+      setAddress({ city: place.city, state: place.state.toUpperCase() });
+      setPostalStatus(`${place.city}, ${place.state.toUpperCase()} filled from ZIP`);
+    }).catch(() => setPostalStatus("ZIP lookup unavailable"));
+  };
+  const changeEvaluation = (type) => {
+    setEvaluationType(type);
+    setBill((current) => ({ ...current, renderingProvider: { ...current.renderingProvider, isAme: type === "ame", isQme: type !== "ame", ...type === "psych_qme" && !current.renderingProvider?.specialty ? { specialty: "Psychiatry" } : {} }, serviceLines: applyBillSubmissionEvaluationModifiers(current.serviceLines, type) }));
+  };
+  const total = submittedLines(bill.serviceLines).reduce((sum, line) => sum + (Number.isFinite(line.charge) ? Number(line.charge) : 0), 0);
   async function submit() {
-    const validation = validateBillSubmission(bill);
+    const clean = { ...cloneBill(bill), serviceLines: submittedLines(bill.serviceLines) };
+    const validation = validateBillSubmission(clean);
     setErrors(validation.fieldErrors);
     setFormError(null);
-    if (!validation.valid) {
-      setFormError("Complete the required fields before submitting.");
-      return;
-    }
-    if (selectedIds.length + uploads.length > MAX_DOCUMENTS) {
-      setFormError(`A bill can include at most ${MAX_DOCUMENTS} attachments.`);
-      return;
-    }
+    if (!validation.valid) return setFormError("Complete the required fields before submitting.");
+    if (selectedIds.length + uploads.length > MAX_DOCUMENTS) return setFormError(`A bill can include at most ${MAX_DOCUMENTS} attachments.`);
     setSubmitting(true);
     try {
-      await onSubmit({ bill: cloneBill(bill), sourceAttachmentIds: selectedIds, uploads });
+      await onSubmit({ bill: clean, sourceAttachmentIds: selectedIds, uploads });
     } catch (caught) {
       setFormError(caught instanceof Error ? caught.message : "Unable to submit the bill.");
     } finally {
       setSubmitting(false);
     }
   }
-  return /* @__PURE__ */ jsxs2(
-    "form",
-    {
-      className,
-      style: { ...mindBillAppearanceStyle(appearance), ...styles.root, ...style },
-      onSubmit: (event) => {
-        event.preventDefault();
-        void submit();
-      },
-      noValidate: true,
-      children: [
-        /* @__PURE__ */ jsxs2("div", { style: styles.heading, children: [
-          /* @__PURE__ */ jsxs2("div", { children: [
-            /* @__PURE__ */ jsx2("h3", { style: styles.title, children: heading }),
-            /* @__PURE__ */ jsx2("p", { style: styles.copy, children: description })
-          ] }),
-          /* @__PURE__ */ jsxs2("span", { style: styles.requiredNote, children: [
-            /* @__PURE__ */ jsx2(RequiredMark, {}),
-            " Required"
-          ] })
-        ] }),
-        /* @__PURE__ */ jsxs2("fieldset", { style: styles.section, disabled: locked, children: [
-          /* @__PURE__ */ jsx2("legend", { style: styles.legend, children: "Patient" }),
-          /* @__PURE__ */ jsxs2("div", { style: styles.grid, children: [
-            /* @__PURE__ */ jsx2(Field2, { label: "First name", required: true, error: errors["patient.firstName"], children: textInput(bill.patient.firstName, (firstName) => setPatient({ firstName }), { required: true }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Middle name", children: textInput(bill.patient.middleName, (middleName) => setPatient({ middleName })) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Last name", required: true, error: errors["patient.lastName"], children: textInput(bill.patient.lastName, (lastName) => setPatient({ lastName }), { required: true }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Date of birth", children: textInput(bill.patient.dateOfBirth, (dateOfBirth) => setOptionalPatient("dateOfBirth", dateOfBirth), { type: "date" }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Phone", children: textInput(bill.patient.phone, (phone) => setPatient({ phone }), { type: "tel" }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Address", required: true, error: errors["patient.address.line1"], children: textInput(bill.patient.address.line1, (line1) => setAddress({ line1 }), { required: true }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "City", required: true, error: errors["patient.address.city"], children: textInput(bill.patient.address.city, (city) => setAddress({ city }), { required: true }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "State", required: true, error: errors["patient.address.state"], children: textInput(bill.patient.address.state, (state) => setAddress({ state }), { required: true, maxLength: 2 }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "ZIP", required: true, error: errors["patient.address.postalCode"], children: textInput(bill.patient.address.postalCode, (postalCode) => setAddress({ postalCode }), { required: true }) })
-          ] })
-        ] }),
-        /* @__PURE__ */ jsxs2("fieldset", { style: styles.section, disabled: locked, children: [
-          /* @__PURE__ */ jsx2("legend", { style: styles.legend, children: "Claim & service" }),
-          /* @__PURE__ */ jsxs2("div", { style: styles.grid, children: [
-            /* @__PURE__ */ jsx2(Field2, { label: "Claim number", required: true, error: errors["claim.claimNumber"], children: textInput(bill.claim.claimNumber, (claimNumber) => setClaim({ claimNumber }), { required: true }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "ADJ number", children: textInput(bill.claim.adjNumber, (adjNumber) => setClaim({ adjNumber })) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Employer", children: textInput(bill.claim.employer, (employer) => setClaim({ employer })) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Date of injury", children: textInput(bill.claim.dateOfInjury, (dateOfInjury) => setOptionalClaim("dateOfInjury", dateOfInjury), { type: "date" }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Claims administrator", children: textInput(bill.claim.claimsAdministrator?.name, (name) => setBill((current) => {
-              const claim = { ...current.claim };
-              if (name) claim.claimsAdministrator = { ...claim.claimsAdministrator, name };
-              else delete claim.claimsAdministrator;
-              return { ...current, claim };
-            })) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Service date", required: true, error: errors["service.date"], children: textInput(bill.service.date, (date) => setService({ date }), { type: "date", required: true }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Diagnoses", children: textInput(diagnoses, (value) => setBill((current) => ({ ...current, diagnoses: value.split(",").map((item) => item.trim()).filter(Boolean) })), { placeholder: "Comma-separated codes" }) })
-          ] })
-        ] }),
-        /* @__PURE__ */ jsxs2("fieldset", { style: styles.section, disabled: locked, children: [
-          /* @__PURE__ */ jsx2("legend", { style: styles.legend, children: "Providers & location" }),
-          /* @__PURE__ */ jsxs2("div", { style: styles.grid, children: [
-            /* @__PURE__ */ jsx2(Field2, { label: "Billing provider", children: textInput(bill.billingProvider?.name, (name) => setBill((current) => ({ ...current, billingProvider: { ...current.billingProvider, name } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Billing tax ID", children: textInput(bill.billingProvider?.taxId, (taxId) => setBill((current) => ({ ...current, billingProvider: { ...current.billingProvider, taxId } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Billing NPI", children: textInput(bill.billingProvider?.npi, (npi) => setBill((current) => ({ ...current, billingProvider: { ...current.billingProvider, npi } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Billing phone", children: textInput(bill.billingProvider?.phone, (phone) => setBill((current) => ({ ...current, billingProvider: { ...current.billingProvider, phone } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Rendering provider", children: textInput(bill.renderingProvider?.name, (name) => setBill((current) => ({ ...current, renderingProvider: { ...current.renderingProvider, name } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Specialty", children: textInput(bill.renderingProvider?.specialty, (specialty) => setBill((current) => ({ ...current, renderingProvider: { ...current.renderingProvider, specialty } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Rendering NPI", children: textInput(bill.renderingProvider?.npi, (npi) => setBill((current) => ({ ...current, renderingProvider: { ...current.renderingProvider, npi } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "License number", children: textInput(bill.renderingProvider?.licenseNumber, (licenseNumber) => setBill((current) => ({ ...current, renderingProvider: { ...current.renderingProvider, licenseNumber } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "License state", children: textInput(bill.renderingProvider?.licenseState, (licenseState) => setBill((current) => ({ ...current, renderingProvider: { ...current.renderingProvider, licenseState } })), { maxLength: 2 }) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Service location", children: textInput(bill.serviceLocation?.name, (name) => setBill((current) => ({ ...current, serviceLocation: { ...current.serviceLocation, name } }))) }),
-            /* @__PURE__ */ jsx2(Field2, { label: "Place of service", children: textInput(bill.serviceLocation?.placeOfServiceCode, (placeOfServiceCode) => setBill((current) => ({ ...current, serviceLocation: { ...current.serviceLocation, placeOfServiceCode } })), { maxLength: 2 }) })
-          ] })
+  return /* @__PURE__ */ jsxs3("form", { className: `${className} mbsf`, style: { ...mindBillAppearanceStyle(appearance), ...style }, onSubmit: (event) => {
+    event.preventDefault();
+    void submit();
+  }, noValidate: true, children: [
+    /* @__PURE__ */ jsx3("style", { children: css }),
+    /* @__PURE__ */ jsxs3("div", { className: "mbsf-head", children: [
+      /* @__PURE__ */ jsxs3("div", { children: [
+        /* @__PURE__ */ jsx3("h3", { className: "mbsf-title", children: heading }),
+        /* @__PURE__ */ jsx3("p", { className: "mbsf-copy", children: description })
+      ] }),
+      /* @__PURE__ */ jsxs3("span", { className: "mbsf-required", children: [
+        /* @__PURE__ */ jsx3(RequiredMark, {}),
+        " Required"
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs3("fieldset", { className: "mbsf-card", disabled: locked, children: [
+      /* @__PURE__ */ jsx3("legend", { className: "mbsf-legend", children: "Patient" }),
+      /* @__PURE__ */ jsxs3("div", { className: "mbsf-grid", children: [
+        /* @__PURE__ */ jsx3(Field2, { label: "First name", required: true, error: errors["patient.firstName"], children: text(bill.patient.firstName, (firstName) => setBill((c) => ({ ...c, patient: { ...c.patient, firstName } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Last name", required: true, error: errors["patient.lastName"], children: text(bill.patient.lastName, (lastName) => setBill((c) => ({ ...c, patient: { ...c.patient, lastName } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Middle name", children: text(bill.patient.middleName, (middleName) => setBill((c) => ({ ...c, patient: { ...c.patient, middleName } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Phone (optional)", children: text(bill.patient.phone, (phone) => setBill((c) => ({ ...c, patient: { ...c.patient, phone } })), { type: "tel" }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Date of birth", required: true, error: errors["patient.dateOfBirth"], children: /* @__PURE__ */ jsx3(TextDateInput, { ariaLabel: "Date of birth", value: bill.patient.dateOfBirth, disabled: locked, required: true, onChange: (dateOfBirth) => setBill((c) => ({ ...c, patient: { ...c.patient, dateOfBirth } })) }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Address", required: true, span: true, error: errors["patient.address.line1"], children: text(bill.patient.address.line1, (line1) => setAddress({ line1 }), { placeholder: "Street address" }) }),
+        /* @__PURE__ */ jsxs3(Field2, { label: "ZIP", required: true, error: errors["patient.address.postalCode"], children: [
+          text(bill.patient.address.postalCode, updatePostalCode, { maxLength: 10 }),
+          postalStatus ? /* @__PURE__ */ jsx3("small", { className: "mbsf-help", children: postalStatus }) : null
         ] }),
-        /* @__PURE__ */ jsxs2("fieldset", { style: styles.section, disabled: locked, children: [
-          /* @__PURE__ */ jsx2("legend", { style: styles.legend, children: "Service lines" }),
-          /* @__PURE__ */ jsx2("div", { style: styles.tableWrap, children: /* @__PURE__ */ jsxs2("table", { "aria-label": "Service lines", style: styles.table, children: [
-            /* @__PURE__ */ jsx2("thead", { children: /* @__PURE__ */ jsxs2("tr", { children: [
-              /* @__PURE__ */ jsxs2("th", { style: styles.th, children: [
-                "Code",
-                /* @__PURE__ */ jsx2(RequiredMark, {})
-              ] }),
-              /* @__PURE__ */ jsx2("th", { style: styles.th, children: "Modifiers" }),
-              /* @__PURE__ */ jsxs2("th", { style: styles.th, children: [
-                "Units",
-                /* @__PURE__ */ jsx2(RequiredMark, {})
-              ] }),
-              bill.billingMode === "professional" ? /* @__PURE__ */ jsxs2("th", { style: styles.th, children: [
-                "Charge",
-                /* @__PURE__ */ jsx2(RequiredMark, {})
-              ] }) : null,
-              /* @__PURE__ */ jsx2("th", { style: styles.th, "aria-label": "Actions" })
-            ] }) }),
-            /* @__PURE__ */ jsx2("tbody", { children: bill.serviceLines.map((line, index) => /* @__PURE__ */ jsxs2("tr", { children: [
-              /* @__PURE__ */ jsxs2("td", { style: styles.td, children: [
-                textInput(line.code, (code) => setLine(index, { code }), { required: true }),
-                errors[`serviceLines.${index}.code`] ? /* @__PURE__ */ jsx2("span", { style: { color: "var(--mb-danger)", fontSize: 12 }, children: errors[`serviceLines.${index}.code`] }) : null
-              ] }),
-              /* @__PURE__ */ jsx2("td", { style: styles.td, children: textInput((line.modifiers ?? []).join(", "), (value) => setLine(index, { modifiers: value.split(",").map((item) => item.trim()).filter(Boolean) })) }),
-              /* @__PURE__ */ jsxs2("td", { style: styles.td, children: [
-                /* @__PURE__ */ jsx2("input", { style: styles.input, type: "number", min: 1, required: true, value: line.units ?? 1, onChange: (event) => setLine(index, { units: Number(event.target.value) }) }),
-                errors[`serviceLines.${index}.units`] ? /* @__PURE__ */ jsx2("span", { style: { color: "var(--mb-danger)", fontSize: 12 }, children: errors[`serviceLines.${index}.units`] }) : null
-              ] }),
-              bill.billingMode === "professional" ? /* @__PURE__ */ jsxs2("td", { style: styles.td, children: [
-                /* @__PURE__ */ jsx2("input", { style: styles.input, type: "number", min: 0, step: "0.01", required: true, value: line.charge ?? "", onChange: (event) => setOptionalLineNumber(index, "charge", event.target.value) }),
-                errors[`serviceLines.${index}.charge`] ? /* @__PURE__ */ jsx2("span", { style: { color: "var(--mb-danger)", fontSize: 12 }, children: errors[`serviceLines.${index}.charge`] }) : null
-              ] }) : null,
-              /* @__PURE__ */ jsx2("td", { style: styles.td, children: /* @__PURE__ */ jsx2("button", { style: styles.secondaryButton, type: "button", disabled: locked || bill.serviceLines.length === 1, onClick: () => setBill((current) => ({ ...current, serviceLines: current.serviceLines.filter((_, lineIndex) => lineIndex !== index) })), children: "Remove" }) })
-            ] }, index)) })
-          ] }) }),
-          errors.serviceLines ? /* @__PURE__ */ jsx2("p", { style: { color: "var(--mb-danger)", fontSize: 12 }, children: errors.serviceLines }) : null,
-          /* @__PURE__ */ jsx2("button", { style: { ...styles.secondaryButton, marginTop: 12 }, type: "button", disabled: locked, onClick: () => setBill((current) => ({ ...current, serviceLines: [...current.serviceLines, { code: "", modifiers: [], units: 1 }] })), children: "+ Add service line" })
+        /* @__PURE__ */ jsx3(Field2, { label: "City", required: true, error: errors["patient.address.city"], children: text(bill.patient.address.city, (city) => setAddress({ city })) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "State", required: true, error: errors["patient.address.state"], children: text(bill.patient.address.state, (state) => setAddress({ state: state.toUpperCase() }), { maxLength: 2 }) })
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs3("fieldset", { className: "mbsf-card", disabled: locked, children: [
+      /* @__PURE__ */ jsx3("legend", { className: "mbsf-legend", children: "Injury & claim" }),
+      /* @__PURE__ */ jsxs3("div", { className: "mbsf-grid", children: [
+        /* @__PURE__ */ jsx3(Field2, { label: "Date of service", required: true, error: errors["service.date"], children: /* @__PURE__ */ jsx3(TextDateInput, { ariaLabel: "Date of service", value: bill.service.date, disabled: locked, required: true, onChange: (date2) => setBill((c) => ({ ...c, service: { ...c.service, date: date2 } })) }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Date of injury", children: /* @__PURE__ */ jsx3(TextDateInput, { ariaLabel: "Date of injury", value: bill.claim.dateOfInjury, disabled: locked, onChange: (dateOfInjury) => setBill((c) => ({ ...c, claim: { ...c.claim, dateOfInjury } })) }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Employer (optional)", children: text(bill.claim.employer, (employer) => setBill((c) => ({ ...c, claim: { ...c.claim, employer } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Claim number", required: true, error: errors["claim.claimNumber"], children: text(bill.claim.claimNumber, (claimNumber) => setBill((c) => ({ ...c, claim: { ...c.claim, claimNumber } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "WCAB / ADJ number (optional)", children: text(bill.claim.adjNumber, (adjNumber) => setBill((c) => ({ ...c, claim: { ...c.claim, adjNumber } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Claims administrator", required: true, span: true, error: errors["claim.claimsAdministrator"], children: /* @__PURE__ */ jsx3(ComboBox, { ariaLabel: "Claims administrator", disabled: locked, loading: payerLoading, value: bill.claim.claimsAdministrator?.name ?? "", placeholder: "Search the payer directory\u2026", options: payerResults.map((payer) => ({ id: payer.id, label: payer.name, detail: [payer.hasElectronic ? "Electronic" : "Work comp", ...payer.states ?? []].join(" \xB7 ") })), onQuery: searchPayers, onSelect: (option) => setBill((c) => ({ ...c, claim: { ...c.claim, claimsAdministrator: { id: option.id, name: option.label } } })) }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Injury description (optional)", span: true, children: text(bill.claim.description, (description2) => setBill((c) => ({ ...c, claim: { ...c.claim, description: description2 } }))) }),
+        /* @__PURE__ */ jsxs3(Field2, { label: "Diagnosis codes (ICD-10)", span: true, children: [
+          /* @__PURE__ */ jsx3("div", { className: "mbsf-chips", children: (bill.diagnoses ?? []).map((code) => {
+            const option = [...diagnosisOptions, ...diagnosisResults].find((item) => item.code === code);
+            return /* @__PURE__ */ jsxs3("span", { className: "mbsf-chip", children: [
+              /* @__PURE__ */ jsx3("strong", { children: code }),
+              option?.description ? ` ${option.description}` : "",
+              /* @__PURE__ */ jsx3("button", { type: "button", "aria-label": `Remove ${code}`, onClick: () => setBill((c) => ({ ...c, diagnoses: (c.diagnoses ?? []).filter((item) => item !== code) })), children: "\xD7" })
+            ] }, code);
+          }) }),
+          /* @__PURE__ */ jsx3(ComboBox, { ariaLabel: "Add diagnosis code", disabled: locked, loading: diagnosisLoading, value: "", placeholder: bill.diagnoses?.length ?? 0 ? `${bill.diagnoses.length} selected \u2014 add more\u2026` : "Search ICD-10 codes\u2026", options: [...new Map([...diagnosisOptions, ...diagnosisResults].map((item) => [item.code, item])).values()].filter((item) => !(bill.diagnoses ?? []).includes(item.code)).map((item) => ({ id: item.code, label: item.code, detail: item.description })), onQuery: searchDiagnoses, onSelect: (option) => setBill((c) => ({ ...c, diagnoses: [.../* @__PURE__ */ new Set([...c.diagnoses ?? [], option.id])] })) })
+        ] })
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs3("fieldset", { className: "mbsf-card", disabled: locked, children: [
+      /* @__PURE__ */ jsx3("legend", { className: "mbsf-legend", children: "Providers & place of service" }),
+      /* @__PURE__ */ jsxs3("div", { className: "mbsf-grid", children: [
+        /* @__PURE__ */ jsx3(Field2, { label: "Billing provider", children: text(bill.billingProvider?.name, (name) => setBill((c) => ({ ...c, billingProvider: { ...c.billingProvider, name } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Billing tax ID", children: text(bill.billingProvider?.taxId, (taxId) => setBill((c) => ({ ...c, billingProvider: { ...c.billingProvider, taxId } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Billing NPI", children: text(bill.billingProvider?.npi, (npi) => setBill((c) => ({ ...c, billingProvider: { ...c.billingProvider, npi } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Billing phone", children: text(bill.billingProvider?.phone, (phone) => setBill((c) => ({ ...c, billingProvider: { ...c.billingProvider, phone } })), { type: "tel" }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Rendering provider", children: text(bill.renderingProvider?.name, (name) => setBill((c) => ({ ...c, renderingProvider: { ...c.renderingProvider, name } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Specialty", children: text(bill.renderingProvider?.specialty, (specialty) => setBill((c) => ({ ...c, renderingProvider: { ...c.renderingProvider, specialty } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Rendering NPI", children: text(bill.renderingProvider?.npi, (npi) => setBill((c) => ({ ...c, renderingProvider: { ...c.renderingProvider, npi } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "License number", children: text(bill.renderingProvider?.licenseNumber, (licenseNumber) => setBill((c) => ({ ...c, renderingProvider: { ...c.renderingProvider, licenseNumber } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "License state", children: text(bill.renderingProvider?.licenseState, (licenseState) => setBill((c) => ({ ...c, renderingProvider: { ...c.renderingProvider, licenseState: licenseState.toUpperCase() } })), { maxLength: 2 }) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Service location", children: text(bill.serviceLocation?.name, (name) => setBill((c) => ({ ...c, serviceLocation: { ...c.serviceLocation, name } }))) }),
+        /* @__PURE__ */ jsx3(Field2, { label: "Place of service", children: text(bill.serviceLocation?.placeOfServiceCode, (placeOfServiceCode) => setBill((c) => ({ ...c, serviceLocation: { ...c.serviceLocation, placeOfServiceCode } })), { maxLength: 2 }) })
+      ] })
+    ] }),
+    /* @__PURE__ */ jsxs3("fieldset", { className: "mbsf-card", disabled: locked, children: [
+      /* @__PURE__ */ jsx3("legend", { className: "mbsf-legend", children: "Evaluation & service lines" }),
+      /* @__PURE__ */ jsx3("p", { className: "mbsf-help", children: "Sets the evaluator/specialty modifier on medical-legal evaluation lines." }),
+      /* @__PURE__ */ jsx3("div", { className: "mbsf-segments", role: "group", "aria-label": "Evaluation type", children: [["qme", "QME (default)"], ["ame", "AME"], ["psych_qme", "Psych QME"]].map(([type, label]) => /* @__PURE__ */ jsx3("button", { className: "mbsf-segment", type: "button", "aria-pressed": evaluationType === type, onClick: () => changeEvaluation(type), children: label }, type)) }),
+      /* @__PURE__ */ jsx3("p", { className: "mbsf-help", children: evaluationType === "ame" ? "Agreed Medical Evaluator \u2014 eligible ML evaluation codes default to modifier -94." : evaluationType === "psych_qme" ? "Psychiatric QME \u2014 eligible ML evaluation codes default to modifier -96 (-95 for ML200)." : "Qualified Medical Evaluator \u2014 eligible ML evaluation codes default to modifier -95." }),
+      /* @__PURE__ */ jsxs3("div", { className: "mbsf-lines", children: [
+        /* @__PURE__ */ jsxs3("div", { className: "mbsf-line-head", children: [
+          /* @__PURE__ */ jsx3("span", { children: "Procedure code" }),
+          /* @__PURE__ */ jsx3("span", { children: "Modifiers" }),
+          /* @__PURE__ */ jsx3("span", { children: "Units" }),
+          /* @__PURE__ */ jsx3("span", { children: "Allowed" }),
+          /* @__PURE__ */ jsx3("span", {}),
+          " "
         ] }),
-        /* @__PURE__ */ jsxs2("fieldset", { style: styles.section, disabled: locked, children: [
-          /* @__PURE__ */ jsx2("legend", { style: styles.legend, children: "Attachments" }),
-          attachments.map((attachment) => /* @__PURE__ */ jsxs2("label", { style: styles.attachment, children: [
-            /* @__PURE__ */ jsx2("input", { type: "checkbox", checked: selectedIds.includes(attachment.id), onChange: (event) => {
-              if (event.target.checked && selectedIds.length + uploads.length >= MAX_DOCUMENTS) {
-                setFormError(`A bill can include at most ${MAX_DOCUMENTS} attachments.`);
-                return;
-              }
-              setSelectedIds((current) => event.target.checked ? [.../* @__PURE__ */ new Set([...current, attachment.id])] : current.filter((id) => id !== attachment.id));
+        bill.serviceLines.map((line, index) => /* @__PURE__ */ jsxs3("div", { className: "mbsf-line", children: [
+          /* @__PURE__ */ jsxs3("div", { children: [
+            /* @__PURE__ */ jsx3(ComboBox, { ariaLabel: `Procedure code ${index + 1}`, disabled: locked, value: line.code, placeholder: "Code\u2026", options: procedures.map((item) => ({ id: item.code, label: item.code, detail: item.description })), onSelect: (option) => {
+              const selected = procedures.find((item) => item.code === option.id);
+              const auto = evaluationModifier(evaluationType, option.id);
+              setLine(index, { code: option.id, ...auto ? { modifiers: [auto, ...(line.modifiers ?? []).filter((item) => !["94", "95", "96"].includes(item.replace(/^-/, "")))] } : line.modifiers ? { modifiers: line.modifiers } : {}, ...selected?.allowedAmount != null ? { charge: selected.allowedAmount * (line.units ?? 1) } : {} });
             } }),
-            /* @__PURE__ */ jsxs2("span", { style: styles.attachmentName, children: [
-              /* @__PURE__ */ jsx2("strong", { children: attachment.fileName }),
-              /* @__PURE__ */ jsx2("span", { style: styles.attachmentMeta, children: attachment.description || documentLabels[attachment.documentType] })
-            ] })
-          ] }, attachment.id)),
-          uploads.map((upload, index) => /* @__PURE__ */ jsxs2("div", { style: styles.attachment, children: [
-            /* @__PURE__ */ jsxs2("span", { style: styles.attachmentName, children: [
-              /* @__PURE__ */ jsx2("strong", { children: upload.file.name }),
-              /* @__PURE__ */ jsxs2("span", { style: styles.attachmentMeta, children: [
-                (upload.file.size / 1024 / 1024).toFixed(1),
-                " MB"
+            line.code ? /* @__PURE__ */ jsx3("small", { className: "mbsf-help", children: procedures.find((item) => item.code === line.code)?.description }) : null,
+            errors[`serviceLines.${index}.code`] ? /* @__PURE__ */ jsx3("small", { className: "mbsf-error", children: errors[`serviceLines.${index}.code`] }) : null
+          ] }),
+          /* @__PURE__ */ jsxs3("div", { children: [
+            /* @__PURE__ */ jsx3("div", { className: "mbsf-chips", children: (line.modifiers ?? []).map((modifier) => /* @__PURE__ */ jsxs3("span", { className: "mbsf-chip", children: [
+              "\u2212",
+              modifier.replace(/^-/, ""),
+              /* @__PURE__ */ jsx3("button", { type: "button", "aria-label": `Remove modifier ${modifier}`, onClick: () => setLine(index, { modifiers: (line.modifiers ?? []).filter((item) => item !== modifier) }), children: "\xD7" })
+            ] }, modifier)) }),
+            /* @__PURE__ */ jsx3(ComboBox, { ariaLabel: `Modifiers ${index + 1}`, disabled: locked, value: "", placeholder: line.modifiers?.length ?? 0 ? `${line.modifiers.length} modifier${line.modifiers.length === 1 ? "" : "s"}` : "Add modifiers\u2026", options: modifiers.filter((item) => !(line.modifiers ?? []).includes(item.code)).map((item) => ({ id: item.code, label: `\u2212${item.code}`, detail: item.description })), onSelect: (option) => setLine(index, { modifiers: [.../* @__PURE__ */ new Set([...line.modifiers ?? [], option.id])] }) })
+          ] }),
+          /* @__PURE__ */ jsxs3("div", { children: [
+            /* @__PURE__ */ jsx3("input", { className: "mbsf-input", "aria-label": `Units ${index + 1}`, type: "number", min: 1, value: line.units ?? 1, onChange: (event) => {
+              const units = Number(event.target.value);
+              const selected = procedures.find((item) => item.code === line.code);
+              setLine(index, { units, ...selected?.allowedAmount != null ? { charge: selected.allowedAmount * units } : {} });
+            } }),
+            errors[`serviceLines.${index}.units`] ? /* @__PURE__ */ jsx3("small", { className: "mbsf-error", children: errors[`serviceLines.${index}.units`] }) : null
+          ] }),
+          /* @__PURE__ */ jsx3("div", { className: "mbsf-money", children: line.charge == null ? "\u2014" : line.charge.toLocaleString(void 0, { style: "currency", currency: "USD" }) }),
+          /* @__PURE__ */ jsx3("button", { className: "mbsf-icon-btn", type: "button", "aria-label": `Remove service line ${index + 1}`, disabled: locked || !lineHasContent(line) && index === bill.serviceLines.length - 1, onClick: () => setBill((c) => ({ ...c, serviceLines: ensureTrailingBillSubmissionLine(c.serviceLines.filter((_, itemIndex) => itemIndex !== index)) })), children: "\xD7" })
+        ] }, index)),
+        /* @__PURE__ */ jsxs3("div", { className: "mbsf-total", children: [
+          /* @__PURE__ */ jsx3("span", { children: "Total" }),
+          /* @__PURE__ */ jsx3("span", { children: total.toLocaleString(void 0, { style: "currency", currency: "USD" }) })
+        ] })
+      ] }),
+      errors.serviceLines ? /* @__PURE__ */ jsx3("p", { className: "mbsf-error", children: errors.serviceLines }) : null
+    ] }),
+    /* @__PURE__ */ jsxs3("fieldset", { className: "mbsf-card", disabled: locked, children: [
+      /* @__PURE__ */ jsx3("legend", { className: "mbsf-legend", children: "Attachments" }),
+      /* @__PURE__ */ jsxs3("div", { className: "mbsf-attach-list", children: [
+        attachments.map((attachment) => {
+          const auto = attachment.autoAttached ?? attachment.documentType === "w9";
+          const selected = selectedIds.includes(attachment.id);
+          return /* @__PURE__ */ jsxs3("div", { className: "mbsf-attach-row", "data-auto": auto, children: [
+            /* @__PURE__ */ jsxs3("label", { className: "mbsf-attach-row", style: { border: 0, padding: 0, flex: 1, justifyContent: "flex-start" }, children: [
+              /* @__PURE__ */ jsx3("input", { type: "checkbox", checked: selected, disabled: locked || auto || attachment.removable === false, onChange: (event) => setSelectedIds((current) => event.target.checked ? [.../* @__PURE__ */ new Set([...current, attachment.id])] : current.filter((id) => id !== attachment.id)) }),
+              /* @__PURE__ */ jsxs3("span", { className: "mbsf-file", children: [
+                /* @__PURE__ */ jsx3("strong", { children: attachment.fileName }),
+                /* @__PURE__ */ jsx3("span", { className: "mbsf-badge", children: auto ? "Auto-attached" : documentLabels[attachment.documentType] }),
+                /* @__PURE__ */ jsx3("span", { className: "mbsf-help", style: { display: "block" }, children: attachment.description || (auto ? "Included automatically with this bill." : documentLabels[attachment.documentType]) })
               ] })
             ] }),
-            /* @__PURE__ */ jsx2("select", { style: { ...styles.input, width: 180 }, value: upload.documentType, onChange: (event) => setUploads((current) => current.map((item, itemIndex) => itemIndex === index ? { ...item, documentType: event.target.value } : item)), children: BILL_SUBMISSION_DOCUMENT_TYPES.map((type) => /* @__PURE__ */ jsx2("option", { value: type, children: documentLabels[type] }, type)) }),
-            /* @__PURE__ */ jsx2("button", { style: styles.secondaryButton, type: "button", onClick: () => setUploads((current) => current.filter((_, itemIndex) => itemIndex !== index)), children: "Remove" })
-          ] }, `${upload.file.name}-${index}`)),
-          !attachments.length && !uploads.length ? /* @__PURE__ */ jsx2("p", { style: styles.copy, children: "No attachments added." }) : null,
-          /* @__PURE__ */ jsxs2("label", { style: { ...styles.secondaryButton, display: "inline-flex", alignItems: "center", marginTop: 14 }, children: [
-            "Add PDF attachments",
-            /* @__PURE__ */ jsx2("input", { hidden: true, type: "file", accept: "application/pdf,.pdf", multiple: true, onChange: (event) => {
-              const files = Array.from(event.target.files ?? []);
-              event.target.value = "";
-              setFormError(null);
-              const invalid = files.find((file) => file.type !== "application/pdf" && !file.name.toLowerCase().endsWith(".pdf"));
-              if (invalid) return setFormError(`${invalid.name} is not a PDF.`);
-              const oversized = files.find((file) => file.size > MAX_PDF_BYTES);
-              if (oversized) return setFormError(`${oversized.name} is larger than 25 MB.`);
-              const nextBytes = [...uploads.map((item) => item.file), ...files].reduce((sum, file) => sum + file.size, 0);
-              if (nextBytes > MAX_UPLOAD_BYTES) return setFormError("Attachments exceed the 100 MB upload limit.");
-              if (selectedIds.length + uploads.length + files.length > MAX_DOCUMENTS) return setFormError(`A bill can include at most ${MAX_DOCUMENTS} attachments.`);
-              setUploads((current) => [...current, ...files.map((file) => ({ file, documentType: "other" }))]);
-            } })
-          ] })
-        ] }),
-        formError ? /* @__PURE__ */ jsx2("div", { style: styles.error, role: "alert", children: formError }) : null,
-        /* @__PURE__ */ jsx2("div", { style: styles.actions, children: /* @__PURE__ */ jsx2("button", { style: { ...styles.submit, opacity: locked ? 0.65 : 1 }, type: "submit", disabled: locked, children: submitting ? "Submitting\u2026" : submitLabel }) })
-      ]
-    }
-  );
+            attachment.previewUrl ? /* @__PURE__ */ jsx3("a", { className: "mbsf-secondary", href: attachment.previewUrl, target: "_blank", rel: "noreferrer", children: "View" }) : null
+          ] }, attachment.id);
+        }),
+        uploads.map((upload, index) => /* @__PURE__ */ jsxs3("div", { className: "mbsf-attach-row", children: [
+          /* @__PURE__ */ jsxs3("span", { className: "mbsf-file", children: [
+            /* @__PURE__ */ jsx3("strong", { children: upload.file.name }),
+            /* @__PURE__ */ jsxs3("span", { className: "mbsf-help", style: { display: "block" }, children: [
+              (upload.file.size / 1024 / 1024).toFixed(1),
+              " MB"
+            ] })
+          ] }),
+          /* @__PURE__ */ jsx3("select", { className: "mbsf-select", style: { width: 190 }, value: upload.documentType, onChange: (event) => setUploads((current) => current.map((item, itemIndex) => itemIndex === index ? { ...item, documentType: event.target.value } : item)), children: BILL_SUBMISSION_DOCUMENT_TYPES.map((type) => /* @__PURE__ */ jsx3("option", { value: type, children: documentLabels[type] }, type)) }),
+          /* @__PURE__ */ jsx3("button", { className: "mbsf-icon-btn", type: "button", "aria-label": `Remove ${upload.file.name}`, onClick: () => setUploads((current) => current.filter((_, itemIndex) => itemIndex !== index)), children: "\xD7" })
+        ] }, `${upload.file.name}-${index}`))
+      ] }),
+      /* @__PURE__ */ jsx3("input", { ref: fileInput, hidden: true, type: "file", accept: "application/pdf,.pdf", multiple: true, onChange: (event) => {
+        if (event.target.files) addFiles(event.target.files);
+        event.target.value = "";
+      } }),
+      /* @__PURE__ */ jsx3("button", { className: "mbsf-drop", "data-active": dragActive, type: "button", onClick: () => fileInput.current?.click(), children: /* @__PURE__ */ jsxs3("span", { children: [
+        /* @__PURE__ */ jsx3("strong", { style: { fontSize: 18 }, children: "Drop additional PDF files here, or click to choose" }),
+        /* @__PURE__ */ jsx3("span", { className: "mbsf-help", style: { display: "block", marginTop: 8 }, children: "Add supporting documents anywhere on this screen." })
+      ] }) })
+    ] }),
+    formError ? /* @__PURE__ */ jsx3("div", { className: "mbsf-alert", role: "alert", children: formError }) : null,
+    /* @__PURE__ */ jsx3("div", { className: "mbsf-actions", children: /* @__PURE__ */ jsx3("button", { className: "mbsf-submit", type: "submit", disabled: locked, children: submitting ? "Submitting\u2026" : submitLabel }) })
+  ] });
 }
 
 // src/connected-bill-status.tsx
 import {
-  useCallback,
+  useCallback as useCallback2,
   useEffect as useEffect3,
   useMemo as useMemo3,
-  useRef as useRef2,
+  useRef as useRef3,
   useState as useState3
 } from "react";
 import {
   DEFAULT_API_BASE_URL,
   DEFAULT_SESSION_ENDPOINT
 } from "@mindbill/browser";
-import { Fragment as Fragment2, jsx as jsx3, jsxs as jsxs3 } from "react/jsx-runtime";
+import { Fragment as Fragment3, jsx as jsx4, jsxs as jsxs4 } from "react/jsx-runtime";
 var DEFAULT_REFRESH_INTERVAL = 6e4;
 async function responseError(response, fallback) {
   const body = await response.json().catch(() => null);
@@ -1670,11 +1840,11 @@ function useBillStatus({
   const [error, setError] = useState3(null);
   const [isLoading, setIsLoading] = useState3(enabled && !initialData);
   const [isRefreshing, setIsRefreshing] = useState3(false);
-  const dataRef = useRef2(initialData);
-  const initialDataRef = useRef2(initialData);
+  const dataRef = useRef3(initialData);
+  const initialDataRef = useRef3(initialData);
   initialDataRef.current = initialData;
-  const activeControllerRef = useRef2(null);
-  const requestSequence = useRef2(0);
+  const activeControllerRef = useRef3(null);
+  const requestSequence = useRef3(0);
   useEffect3(() => {
     const seed = initialDataRef.current;
     dataRef.current = seed;
@@ -1684,7 +1854,7 @@ function useBillStatus({
     activeControllerRef.current?.abort();
     return () => activeControllerRef.current?.abort();
   }, [client, enabled]);
-  const load = useCallback(async () => {
+  const load = useCallback2(async () => {
     if (!enabled || !billId) return;
     const sequence = ++requestSequence.current;
     activeControllerRef.current?.abort();
@@ -1747,17 +1917,17 @@ function ConnectedBillStatus({
 }) {
   const status = useBillStatus(options);
   if (status.isLoading && !status.data) {
-    return /* @__PURE__ */ jsx3(Fragment2, { children: loadingFallback ?? /* @__PURE__ */ jsx3("div", { role: "status", children: "Loading bill status\u2026" }) });
+    return /* @__PURE__ */ jsx4(Fragment3, { children: loadingFallback ?? /* @__PURE__ */ jsx4("div", { role: "status", children: "Loading bill status\u2026" }) });
   }
   if (status.error && !status.data) {
-    return /* @__PURE__ */ jsx3(Fragment2, { children: errorFallback?.(status.error, status.refresh) ?? /* @__PURE__ */ jsxs3("div", { role: "alert", children: [
+    return /* @__PURE__ */ jsx4(Fragment3, { children: errorFallback?.(status.error, status.refresh) ?? /* @__PURE__ */ jsxs4("div", { role: "alert", children: [
       status.error.message,
       " ",
-      /* @__PURE__ */ jsx3("button", { type: "button", onClick: () => void status.refresh(), children: "Retry" })
+      /* @__PURE__ */ jsx4("button", { type: "button", onClick: () => void status.refresh(), children: "Retry" })
     ] }) });
   }
   if (!status.data) return null;
-  return /* @__PURE__ */ jsx3(
+  return /* @__PURE__ */ jsx4(
     BillStatusSummary,
     {
       status: status.data.state,
@@ -1776,7 +1946,7 @@ function ConnectedBillStatus({
 }
 
 // src/bill-lifecycle-surfaces.tsx
-import { jsx as jsx4, jsxs as jsxs4 } from "react/jsx-runtime";
+import { jsx as jsx5, jsxs as jsxs5 } from "react/jsx-runtime";
 function visibleBillLifecycleActions(actions, showUnavailable = false) {
   return actions.filter((action) => action.enabled || showUnavailable);
 }
@@ -1791,17 +1961,15 @@ function BillLifecycleActions({
 }) {
   const visible = visibleBillLifecycleActions(actions, showUnavailable);
   if (!visible.length) return null;
-  return /* @__PURE__ */ jsxs4("div", { className: classes("mb-lifecycle-actions", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill actions", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    visible.map((action) => /* @__PURE__ */ jsxs4("div", { className: "mb-lifecycle-action", children: [
-      /* @__PURE__ */ jsx4("button", { type: "button", className: action.primary ? "mb-action-button is-primary" : "mb-action-button", disabled: disabled || !action.enabled, onClick: () => onAction(action), children: action.label }),
-      !action.enabled && action.reason ? /* @__PURE__ */ jsx4("span", { className: "mb-action-reason", children: action.reason }) : null
+  return /* @__PURE__ */ jsxs5("div", { className: classes("mb-lifecycle-actions", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill actions", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    visible.map((action) => /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-action", children: [
+      /* @__PURE__ */ jsx5("button", { type: "button", className: action.primary ? "mb-action-button is-primary" : "mb-action-button", disabled: disabled || !action.enabled, onClick: () => onAction(action), children: action.label }),
+      !action.enabled && action.reason ? /* @__PURE__ */ jsx5("span", { className: "mb-action-reason", children: action.reason }) : null
     ] }, action.id))
   ] });
 }
 var activityLabels = {
-  "bill.created": "Bill created",
-  "bill.draft": "Bill saved",
   "bill.scrub_failed": "Submission needs attention",
   "bill.submitted": "Bill submitted",
   "bill.accepted": "Bill accepted",
@@ -1827,21 +1995,21 @@ function defaultFormatDate(createdAt) {
   return new Intl.DateTimeFormat(void 0, { dateStyle: "medium", timeStyle: "short" }).format(parsed);
 }
 function BillActivityTimeline({ events, emptyLabel = "No bill activity yet.", appearance, className, style, formatDate = defaultFormatDate }) {
-  return /* @__PURE__ */ jsxs4("section", { className: classes("mb-surface mb-activity", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill activity", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    /* @__PURE__ */ jsxs4("header", { className: "mb-surface-heading", children: [
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("strong", { children: "Bill history" }),
-        /* @__PURE__ */ jsx4("span", { children: "Submission, payer responses, follow-up, and payments." })
+  return /* @__PURE__ */ jsxs5("section", { className: classes("mb-surface mb-activity", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill activity", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    /* @__PURE__ */ jsxs5("header", { className: "mb-surface-heading", children: [
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("strong", { children: "Bill history" }),
+        /* @__PURE__ */ jsx5("span", { children: "Submission, payer responses, follow-up, and payments." })
       ] }),
-      /* @__PURE__ */ jsx4("span", { children: events.length })
+      /* @__PURE__ */ jsx5("span", { children: events.length })
     ] }),
-    !events.length ? /* @__PURE__ */ jsx4("p", { className: "mb-activity-empty", children: emptyLabel }) : /* @__PURE__ */ jsx4("ol", { className: "mb-activity-list", children: events.map((event) => /* @__PURE__ */ jsxs4("li", { className: "mb-activity-item", children: [
-      /* @__PURE__ */ jsx4("span", { className: "mb-activity-marker", "aria-hidden": "true" }),
-      /* @__PURE__ */ jsxs4("div", { className: "mb-activity-content", children: [
-        /* @__PURE__ */ jsx4("strong", { children: event.title ?? billActivityEventLabel(event.type) }),
-        event.description ? /* @__PURE__ */ jsx4("p", { children: event.description }) : null,
-        /* @__PURE__ */ jsxs4("span", { children: [
+    !events.length ? /* @__PURE__ */ jsx5("p", { className: "mb-activity-empty", children: emptyLabel }) : /* @__PURE__ */ jsx5("ol", { className: "mb-activity-list", children: events.map((event) => /* @__PURE__ */ jsxs5("li", { className: "mb-activity-item", children: [
+      /* @__PURE__ */ jsx5("span", { className: "mb-activity-marker", "aria-hidden": "true" }),
+      /* @__PURE__ */ jsxs5("div", { className: "mb-activity-content", children: [
+        /* @__PURE__ */ jsx5("strong", { children: event.title ?? billActivityEventLabel(event.type) }),
+        event.description ? /* @__PURE__ */ jsx5("p", { children: event.description }) : null,
+        /* @__PURE__ */ jsxs5("span", { children: [
           formatDate(event.createdAt),
           event.actor ? ` \xB7 ${event.actor}` : ""
         ] })
@@ -1850,39 +2018,35 @@ function BillActivityTimeline({ events, emptyLabel = "No bill activity yet.", ap
   ] });
 }
 var lifecycleStages = [
-  { id: "created", label: "Created" },
   { id: "submitted", label: "Submitted" },
   { id: "accepted", label: "Accepted" },
-  { id: "response", label: "Payer response" },
-  { id: "follow_up", label: "Follow-up" },
+  { id: "processed", label: "Processed" },
   { id: "closed", label: "Closed" }
 ];
 function billLifecycleStage(state) {
   const value = state.toLowerCase();
   if (value.includes("closed") || value.includes("written_off")) return "closed";
-  if (value.includes("second_review") || value.includes("ibr") || value.includes("lien") || value.includes("appeal")) return "follow_up";
-  if (value.includes("processed") || value.includes("paid") || value.includes("denied") || value.includes("rejected") || value.includes("response")) return "response";
+  if (value.includes("processed") || value.includes("paid") || value.includes("denied") || value.includes("reject") || value.includes("partial") || value.includes("response") || value.includes("second_review") || value.includes("ibr") || value.includes("lien") || value.includes("appeal")) return "processed";
   if (value.includes("accepted")) return "accepted";
-  if (value.includes("submitted") || value.includes("queued") || value.includes("sent")) return "submitted";
-  return "created";
+  return "submitted";
 }
 function BillLifecycleProgress({ state, nativeStatus, submittedAt, agingDays, appearance, className, style }) {
   const current = billLifecycleStage(state);
   const currentIndex = lifecycleStages.findIndex((stage) => stage.id === current);
-  return /* @__PURE__ */ jsxs4("section", { className: classes("mb-surface mb-progress", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill lifecycle", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    /* @__PURE__ */ jsx4("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs4("div", { children: [
-      /* @__PURE__ */ jsx4("strong", { children: humanize(nativeStatus || state) }),
-      /* @__PURE__ */ jsxs4("span", { children: [
-        submittedAt ? `Submitted ${defaultFormatDate(submittedAt)}` : "Not submitted",
+  return /* @__PURE__ */ jsxs5("section", { className: classes("mb-surface mb-progress", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill lifecycle", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    /* @__PURE__ */ jsx5("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs5("div", { children: [
+      /* @__PURE__ */ jsx5("strong", { children: humanize(nativeStatus || state) }),
+      /* @__PURE__ */ jsxs5("span", { children: [
+        submittedAt ? `Submitted ${defaultFormatDate(submittedAt)}` : "Submitted",
         typeof agingDays === "number" ? ` \xB7 ${agingDays} days old` : ""
       ] })
     ] }) }),
-    /* @__PURE__ */ jsx4("ol", { className: "mb-progress-list", children: lifecycleStages.map((stage, index) => {
+    /* @__PURE__ */ jsx5("ol", { className: "mb-progress-list", children: lifecycleStages.map((stage, index) => {
       const status = index < currentIndex ? "complete" : index === currentIndex ? "current" : "upcoming";
-      return /* @__PURE__ */ jsxs4("li", { className: `is-${status}`, "aria-current": status === "current" ? "step" : void 0, children: [
-        /* @__PURE__ */ jsx4("span", { "aria-hidden": "true", children: status === "complete" ? "\u2713" : index + 1 }),
-        /* @__PURE__ */ jsx4("b", { children: stage.label })
+      return /* @__PURE__ */ jsxs5("li", { className: `is-${status}`, "aria-current": status === "current" ? "step" : void 0, children: [
+        /* @__PURE__ */ jsx5("span", { "aria-hidden": "true", children: status === "complete" ? "\u2713" : index + 1 }),
+        /* @__PURE__ */ jsx5("b", { children: stage.label })
       ] }, stage.id);
     }) })
   ] });
@@ -1896,45 +2060,45 @@ function BillSnapshotSummary({ bill, patient, injury, delivery, appearance, clas
     ["Charged", currency(bill.totalCharge)],
     ["Balance", currency(bill.balanceDue)]
   ];
-  return /* @__PURE__ */ jsxs4("section", { className: classes("mb-surface mb-snapshot", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill snapshot", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    /* @__PURE__ */ jsx4("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs4("div", { children: [
-      /* @__PURE__ */ jsx4("strong", { children: "Bill snapshot" }),
-      /* @__PURE__ */ jsxs4("span", { children: [
+  return /* @__PURE__ */ jsxs5("section", { className: classes("mb-surface mb-snapshot", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Bill snapshot", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    /* @__PURE__ */ jsx5("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs5("div", { children: [
+      /* @__PURE__ */ jsx5("strong", { children: "Bill snapshot" }),
+      /* @__PURE__ */ jsxs5("span", { children: [
         "Bill #",
         bill.billNumber
       ] })
     ] }) }),
-    /* @__PURE__ */ jsx4("dl", { children: values.map(([label, value]) => /* @__PURE__ */ jsxs4("div", { children: [
-      /* @__PURE__ */ jsx4("dt", { children: label }),
-      /* @__PURE__ */ jsx4("dd", { children: value })
+    /* @__PURE__ */ jsx5("dl", { children: values.map(([label, value]) => /* @__PURE__ */ jsxs5("div", { children: [
+      /* @__PURE__ */ jsx5("dt", { children: label }),
+      /* @__PURE__ */ jsx5("dd", { children: value })
     ] }, label)) })
   ] });
 }
 function BillRemittanceCard({ remittance, appearance, className, style }) {
-  return /* @__PURE__ */ jsxs4("section", { className: classes("mb-surface mb-remittance", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Remittance summary", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    /* @__PURE__ */ jsx4("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs4("div", { children: [
-      /* @__PURE__ */ jsx4("strong", { children: "Remittance" }),
-      /* @__PURE__ */ jsx4("span", { children: "Amounts reported by the payer and posted to the bill." })
+  return /* @__PURE__ */ jsxs5("section", { className: classes("mb-surface mb-remittance", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Remittance summary", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    /* @__PURE__ */ jsx5("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs5("div", { children: [
+      /* @__PURE__ */ jsx5("strong", { children: "Remittance" }),
+      /* @__PURE__ */ jsx5("span", { children: "Amounts reported by the payer and posted to the bill." })
     ] }) }),
-    /* @__PURE__ */ jsxs4("dl", { children: [
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("dt", { children: "Payer reported" }),
-        /* @__PURE__ */ jsx4("dd", { children: remittance.payerReportedPaid === null ? "\u2014" : currency(remittance.payerReportedPaid) })
+    /* @__PURE__ */ jsxs5("dl", { children: [
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("dt", { children: "Payer reported" }),
+        /* @__PURE__ */ jsx5("dd", { children: remittance.payerReportedPaid === null ? "\u2014" : currency(remittance.payerReportedPaid) })
       ] }),
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("dt", { children: "Posted" }),
-        /* @__PURE__ */ jsx4("dd", { children: currency(remittance.totalPaid) })
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("dt", { children: "Posted" }),
+        /* @__PURE__ */ jsx5("dd", { children: currency(remittance.totalPaid) })
       ] }),
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("dt", { children: "Balance" }),
-        /* @__PURE__ */ jsx4("dd", { children: currency(remittance.balanceDue) })
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("dt", { children: "Balance" }),
+        /* @__PURE__ */ jsx5("dd", { children: currency(remittance.balanceDue) })
       ] })
     ] }),
-    remittance.denialReason ? /* @__PURE__ */ jsxs4("div", { className: "mb-denial", children: [
-      /* @__PURE__ */ jsx4("strong", { children: "Denial reason" }),
-      /* @__PURE__ */ jsx4("p", { children: remittance.denialReason })
+    remittance.denialReason ? /* @__PURE__ */ jsxs5("div", { className: "mb-denial", children: [
+      /* @__PURE__ */ jsx5("strong", { children: "Denial reason" }),
+      /* @__PURE__ */ jsx5("p", { children: remittance.denialReason })
     ] }) : null
   ] });
 }
@@ -1949,42 +2113,42 @@ function BillPayerContactCard({ delivery, appearance, className, style }) {
     delivery.contacts.portalUrl ? ["Portal", "Open payer portal", delivery.contacts.portalUrl] : null
   ].filter(Boolean);
   if (!delivery.payerName && !contacts.length) return null;
-  return /* @__PURE__ */ jsxs4("section", { className: classes("mb-surface mb-contacts", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Payer contact information", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    /* @__PURE__ */ jsx4("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs4("div", { children: [
-      /* @__PURE__ */ jsx4("strong", { children: delivery.payerName || "Claims administrator" }),
-      /* @__PURE__ */ jsx4("span", { children: "Billing and follow-up contacts." })
+  return /* @__PURE__ */ jsxs5("section", { className: classes("mb-surface mb-contacts", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Payer contact information", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    /* @__PURE__ */ jsx5("header", { className: "mb-surface-heading", children: /* @__PURE__ */ jsxs5("div", { children: [
+      /* @__PURE__ */ jsx5("strong", { children: delivery.payerName || "Claims administrator" }),
+      /* @__PURE__ */ jsx5("span", { children: "Billing and follow-up contacts." })
     ] }) }),
-    !contacts.length ? /* @__PURE__ */ jsx4("p", { className: "mb-empty", children: "No payer contact details are available." }) : /* @__PURE__ */ jsx4("dl", { children: contacts.map(([label, value, href]) => /* @__PURE__ */ jsxs4("div", { children: [
-      /* @__PURE__ */ jsx4("dt", { children: label }),
-      /* @__PURE__ */ jsx4("dd", { children: href ? /* @__PURE__ */ jsx4("a", { href, target: label === "Portal" ? "_blank" : void 0, rel: label === "Portal" ? "noreferrer noopener" : void 0, children: value }) : value })
+    !contacts.length ? /* @__PURE__ */ jsx5("p", { className: "mb-empty", children: "No payer contact details are available." }) : /* @__PURE__ */ jsx5("dl", { children: contacts.map(([label, value, href]) => /* @__PURE__ */ jsxs5("div", { children: [
+      /* @__PURE__ */ jsx5("dt", { children: label }),
+      /* @__PURE__ */ jsx5("dd", { children: href ? /* @__PURE__ */ jsx5("a", { href, target: label === "Portal" ? "_blank" : void 0, rel: label === "Portal" ? "noreferrer noopener" : void 0, children: value }) : value })
     ] }, label)) })
   ] });
 }
 function BillPaymentLedger({ payments, appearance, className, style }) {
-  return /* @__PURE__ */ jsxs4("section", { className: classes("mb-surface mb-payments", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Payment ledger", children: [
-    /* @__PURE__ */ jsx4("style", { children: lifecycleSurfaceStyles }),
-    /* @__PURE__ */ jsxs4("header", { className: "mb-surface-heading", children: [
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("strong", { children: "Payments" }),
-        /* @__PURE__ */ jsx4("span", { children: "Payments posted to this bill." })
+  return /* @__PURE__ */ jsxs5("section", { className: classes("mb-surface mb-payments", className), style: mindBillAppearanceStyle(appearance, style), "aria-label": "Payment ledger", children: [
+    /* @__PURE__ */ jsx5("style", { children: lifecycleSurfaceStyles }),
+    /* @__PURE__ */ jsxs5("header", { className: "mb-surface-heading", children: [
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("strong", { children: "Payments" }),
+        /* @__PURE__ */ jsx5("span", { children: "Payments posted to this bill." })
       ] }),
-      /* @__PURE__ */ jsx4("span", { children: payments.length })
+      /* @__PURE__ */ jsx5("span", { children: payments.length })
     ] }),
-    !payments.length ? /* @__PURE__ */ jsx4("p", { className: "mb-empty", children: "No payments posted." }) : /* @__PURE__ */ jsx4("div", { className: "mb-payment-list", children: payments.map((payment) => /* @__PURE__ */ jsxs4("article", { children: [
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("strong", { children: currency(payment.amount) }),
-        /* @__PURE__ */ jsxs4("span", { children: [
+    !payments.length ? /* @__PURE__ */ jsx5("p", { className: "mb-empty", children: "No payments posted." }) : /* @__PURE__ */ jsx5("div", { className: "mb-payment-list", children: payments.map((payment) => /* @__PURE__ */ jsxs5("article", { children: [
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("strong", { children: currency(payment.amount) }),
+        /* @__PURE__ */ jsxs5("span", { children: [
           humanize(payment.status || "posted"),
           " \xB7 ",
           payment.method.toUpperCase()
         ] })
       ] }),
-      /* @__PURE__ */ jsxs4("div", { children: [
-        /* @__PURE__ */ jsx4("span", { children: payment.checkNumber ? `#${payment.checkNumber}` : payment.source.toUpperCase() }),
-        /* @__PURE__ */ jsx4("span", { children: payment.depositDate || defaultFormatDate(payment.postedAt) })
+      /* @__PURE__ */ jsxs5("div", { children: [
+        /* @__PURE__ */ jsx5("span", { children: payment.checkNumber ? `#${payment.checkNumber}` : payment.source.toUpperCase() }),
+        /* @__PURE__ */ jsx5("span", { children: payment.depositDate || defaultFormatDate(payment.postedAt) })
       ] }),
-      payment.note ? /* @__PURE__ */ jsx4("p", { children: payment.note }) : null
+      payment.note ? /* @__PURE__ */ jsx5("p", { children: payment.note }) : null
     ] }, payment.id)) })
   ] });
 }
@@ -2011,10 +2175,10 @@ var lifecycleSurfaceStyles = `
 
 // src/connected-bill-lifecycle.tsx
 import {
-  useCallback as useCallback2,
+  useCallback as useCallback3,
   useEffect as useEffect4,
   useMemo as useMemo4,
-  useRef as useRef3,
+  useRef as useRef4,
   useState as useState4
 } from "react";
 import {
@@ -2023,15 +2187,15 @@ import {
   createBillLifecycleClient
 } from "@mindbill/browser";
 import { createBillLifecycleClient as createBillLifecycleClient2 } from "@mindbill/browser";
-import { Fragment as Fragment3, jsx as jsx5, jsxs as jsxs5 } from "react/jsx-runtime";
+import { Fragment as Fragment4, jsx as jsx6, jsxs as jsxs6 } from "react/jsx-runtime";
 var DEFAULT_REFRESH_INTERVAL2 = 6e4;
-function openPdf(blob, filename) {
+function downloadBlob(blob, filename, open = false) {
   const url = URL.createObjectURL(blob);
   const link = document.createElement("a");
   link.href = url;
-  link.target = "_blank";
   link.rel = "noopener noreferrer";
   link.download = filename;
+  if (open) link.target = "_blank";
   link.click();
   window.setTimeout(() => URL.revokeObjectURL(url), 6e4);
 }
@@ -2045,17 +2209,12 @@ function useBillLifecycle({
   initialData = null,
   fetch: fetchOverride
 }) {
-  const billId = providedBillId;
   const [data, setData] = useState4(initialData);
   const [error, setError] = useState4(null);
   const [isLoading, setIsLoading] = useState4(enabled && !initialData);
   const [isRefreshing, setIsRefreshing] = useState4(false);
   const [isMutating, setIsMutating] = useState4(false);
-  const mounted = useRef3(true);
-  useEffect4(() => {
-    setData(initialData);
-    setError(null);
-  }, [initialData, providedBillId]);
+  const mounted = useRef4(true);
   const client = useMemo4(() => createBillLifecycleClient({
     billId: providedBillId,
     sessionEndpoint,
@@ -2063,6 +2222,10 @@ function useBillLifecycle({
     apiBaseUrl,
     fetch: fetchOverride
   }), [apiBaseUrl, fetchOverride, getSession, providedBillId, sessionEndpoint]);
+  useEffect4(() => {
+    setData(initialData);
+    setError(null);
+  }, [initialData, providedBillId]);
   useEffect4(() => {
     mounted.current = true;
     return () => {
@@ -2070,7 +2233,7 @@ function useBillLifecycle({
       client.clearSession();
     };
   }, [client]);
-  const refresh = useCallback2(async () => {
+  const refresh = useCallback3(async () => {
     if (!enabled) return;
     setIsRefreshing(true);
     try {
@@ -2079,8 +2242,7 @@ function useBillLifecycle({
       setData(next);
       setError(null);
     } catch (cause) {
-      if (!mounted.current) return;
-      setError(cause instanceof Error ? cause : new Error("Bill could not be loaded."));
+      if (mounted.current) setError(cause instanceof Error ? cause : new Error("Bill could not be loaded."));
     } finally {
       if (mounted.current) {
         setIsLoading(false);
@@ -2099,7 +2261,7 @@ function useBillLifecycle({
       window.removeEventListener("focus", onFocus);
     };
   }, [enabled, refresh, refreshInterval]);
-  const mutate = useCallback2(async (task) => {
+  const mutate = useCallback3(async (task) => {
     setIsMutating(true);
     setError(null);
     try {
@@ -2114,364 +2276,273 @@ function useBillLifecycle({
       if (mounted.current) setIsMutating(false);
     }
   }, []);
-  const searchClaimsAdministrators = useCallback2(
-    (query, claimNumber) => client.searchClaimsAdministrators(query, claimNumber),
-    [client]
-  );
-  const getDeliveryOptions = useCallback2(
-    () => client.getDeliveryOptions(),
-    [client]
-  );
-  const closeBill = useCallback2(
-    (input) => mutate(() => client.closeBill(input)),
-    [client, mutate]
-  );
-  const postPayment = useCallback2(
-    (input) => mutate(() => client.postPayment(input)),
-    [client, mutate]
-  );
-  const submitSecondReview = useCallback2(
-    (input) => mutate(() => client.submitSecondReview(input)),
-    [client, mutate]
-  );
-  const openAttachment = useCallback2(async (attachment) => {
-    openPdf(await client.getAttachment(attachment.id), attachment.filename);
+  const openAttachment = useCallback3(async (attachment) => {
+    downloadBlob(await client.getAttachment(attachment.id), attachment.filename, true);
   }, [client]);
-  const openEor = useCallback2(async (document2) => {
-    openPdf(await client.getEor(document2.id), document2.filename);
+  const openEor = useCallback3(async (document2) => {
+    downloadBlob(await client.getEor(document2.id), document2.filename, true);
   }, [client]);
+  const downloadPacket = useCallback3(async () => {
+    const packet = await client.getPacket();
+    downloadBlob(packet, `mindbill-${data?.bill.billNumber ?? providedBillId}-submission-packet.pdf`);
+  }, [client, data?.bill.billNumber, providedBillId]);
   return {
-    billId,
+    billId: providedBillId,
     data,
     error,
     isLoading,
     isRefreshing,
     isMutating,
     refresh,
-    searchClaimsAdministrators,
-    getDeliveryOptions,
+    searchClaimsAdministrators: (query, claimNumber) => client.searchClaimsAdministrators(query, claimNumber),
+    getDeliveryOptions: () => client.getDeliveryOptions(),
     openAttachment,
     openEor,
-    closeBill,
-    postPayment,
-    submitSecondReview
+    downloadPacket,
+    closeBill: (input) => mutate(() => client.closeBill(input)),
+    reopenBill: (input) => mutate(() => client.reopenBill(input)),
+    postPayment: (input) => mutate(() => client.postPayment(input)),
+    submitSecondReview: (input) => mutate(() => client.submitSecondReview(input))
   };
 }
-function LifecycleDialog({
-  children,
-  title,
-  onClose
-}) {
-  const dialog = useRef3(null);
+function LifecycleDialog({ children, title, onClose }) {
+  const dialog = useRef4(null);
   useEffect4(() => {
     const previous = document.activeElement;
     dialog.current?.focus();
-    const onKeyDown = (event) => {
-      if (event.key === "Escape") onClose();
-    };
+    const onKeyDown = (event) => event.key === "Escape" && onClose();
     document.addEventListener("keydown", onKeyDown);
     return () => {
       document.removeEventListener("keydown", onKeyDown);
       previous?.focus();
     };
   }, [onClose]);
-  return /* @__PURE__ */ jsx5("div", { className: "mb-lifecycle-dialog-backdrop", onMouseDown: (event) => {
-    if (event.currentTarget === event.target) onClose();
-  }, children: /* @__PURE__ */ jsxs5("div", { ref: dialog, className: "mb-lifecycle-dialog", role: "dialog", "aria-modal": "true", "aria-label": title, tabIndex: -1, children: [
-    /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-dialog-close", "aria-label": "Close", onClick: onClose, children: "\xD7" }),
+  return /* @__PURE__ */ jsx6("div", { className: "mb-lifecycle-dialog-backdrop", onMouseDown: (event) => event.currentTarget === event.target && onClose(), children: /* @__PURE__ */ jsxs6("div", { ref: dialog, className: "mb-lifecycle-dialog", role: "dialog", "aria-modal": "true", "aria-label": title, tabIndex: -1, children: [
+    /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-dialog-close", "aria-label": "Close", onClick: onClose, children: "\xD7" }),
     children
   ] }) });
 }
-function dateInputValue() {
+function today() {
   const now = /* @__PURE__ */ new Date();
-  const offset = now.getTimezoneOffset() * 6e4;
-  return new Date(now.getTime() - offset).toISOString().slice(0, 10);
+  return new Date(now.getTime() - now.getTimezoneOffset() * 6e4).toISOString().slice(0, 10);
 }
-function ConnectedBillLifecycle({
-  appearance,
-  className,
-  style,
-  loadingFallback,
-  errorFallback,
-  onChanged,
-  ...options
-}) {
+function stateLabel(state) {
+  return state.replace(/[._-]+/g, " ").replace(/\b\w/g, (letter) => letter.toUpperCase());
+}
+function actionPanel(action) {
+  if (action.id === "second_review") return "second_review";
+  if (action.id === "post_payment") return "payment";
+  if (action.id === "close") return "close";
+  if (action.id === "reopen") return "reopen";
+  return "";
+}
+function ConnectedBillLifecycle({ appearance, className, style, loadingFallback, errorFallback, onChanged, ...options }) {
   const lifecycle = useBillLifecycle(options);
   const { data } = lifecycle;
+  const [tab, setTab] = useState4("details");
   const [panel, setPanel] = useState4("");
   const [notice, setNotice] = useState4("");
-  const [closeReason, setCloseReason] = useState4("");
-  const [payment, setPayment] = useState4({
-    amount: 0,
-    method: "check",
-    checkNumber: "",
-    depositDate: dateInputValue(),
-    note: ""
-  });
-  const [review, setReview] = useState4({
-    reason: "",
-    payerClaimControlNumber: "",
-    disputedAmount: void 0,
-    attachmentIds: [],
-    route: "ebill"
-  });
-  const lastData = useRef3(null);
-  const closePanel = useCallback2(() => setPanel(""), []);
+  const [reason, setReason] = useState4("");
+  const [payment, setPayment] = useState4({ amount: 0, method: "check", checkNumber: "", depositDate: today(), note: "" });
+  const [review, setReview] = useState4({ reason: "", payerClaimControlNumber: "", disputedAmount: void 0, attachmentIds: [], route: "ebill" });
+  const lastData = useRef4(null);
   useEffect4(() => {
     if (!data || data === lastData.current) return;
     lastData.current = data;
     onChanged?.(data);
-    setPayment((current) => ({
-      ...current,
-      amount: current.amount > 0 ? current.amount : data.bill.balanceDue
-    }));
+    setPayment((current) => ({ ...current, amount: current.amount > 0 ? current.amount : data.bill.balanceDue }));
     setReview((current) => ({
       ...current,
       disputedAmount: current.disputedAmount ?? data.bill.balanceDue,
-      attachmentIds: current.attachmentIds.length ? current.attachmentIds.filter((id) => data.bill.attachments.some((doc) => doc.id === id)) : data.bill.attachments.map((doc) => doc.id)
+      attachmentIds: current.attachmentIds.length ? current.attachmentIds.filter((id) => data.bill.attachments.some((document2) => document2.id === id)) : data.bill.attachments.map((document2) => document2.id)
     }));
   }, [data, onChanged]);
-  if (lifecycle.isLoading && !data) {
-    return /* @__PURE__ */ jsx5(Fragment3, { children: loadingFallback ?? /* @__PURE__ */ jsx5("div", { className: "mb-lifecycle-loading", children: "Loading billing\u2026" }) });
-  }
+  if (lifecycle.isLoading && !data) return /* @__PURE__ */ jsx6(Fragment4, { children: loadingFallback ?? /* @__PURE__ */ jsx6("div", { className: "mb-lifecycle-loading", children: "Loading bill\u2026" }) });
   if (!data) {
     const error = lifecycle.error ?? new Error("Bill could not be loaded.");
-    return /* @__PURE__ */ jsx5(Fragment3, { children: errorFallback?.(error, lifecycle.refresh) ?? /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-error", role: "alert", children: [
-      /* @__PURE__ */ jsx5("strong", { children: "Billing is unavailable." }),
-      /* @__PURE__ */ jsx5("span", { children: error.message }),
-      /* @__PURE__ */ jsx5("button", { type: "button", onClick: () => void lifecycle.refresh(), children: "Try again" })
+    return /* @__PURE__ */ jsx6(Fragment4, { children: errorFallback?.(error, lifecycle.refresh) ?? /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-error", role: "alert", children: [
+      /* @__PURE__ */ jsx6("strong", { children: "Billing is unavailable." }),
+      /* @__PURE__ */ jsx6("span", { children: error.message }),
+      /* @__PURE__ */ jsx6("button", { type: "button", onClick: () => void lifecycle.refresh(), children: "Try again" })
     ] }) });
   }
-  const actionMap = new Map(data.lifecycle.actions.map((action) => [action.id, action]));
-  const has = (id) => actionMap.get(id);
-  const selectPanel = (next) => {
-    setNotice("");
-    setPanel((current) => current === next ? "" : next);
-  };
   const complete = async (message, task) => {
     setNotice("");
     try {
       await task();
       setPanel("");
+      setReason("");
       setNotice(message);
     } catch {
     }
   };
-  const actionButtons = data.lifecycle.actions.filter((action) => action.id !== "view_eor" && action.id !== "independent_bill_review").map((action) => ({
-    ...action,
-    onClick: () => {
-      if (!action.enabled) return;
-      if (action.id === "second_review") selectPanel("second_review");
-      if (action.id === "post_payment") selectPanel("payment");
-      if (action.id === "close") selectPanel("close");
-    },
-    disabled: !action.enabled || lifecycle.isMutating
-  }));
-  return /* @__PURE__ */ jsxs5("section", { className: ["mb-connected-lifecycle", className].filter(Boolean).join(" "), style: mindBillAppearanceStyle(appearance, style), children: [
-    /* @__PURE__ */ jsx5("style", { children: CONNECTED_LIFECYCLE_STYLES }),
-    /* @__PURE__ */ jsx5("style", { children: CONNECTED_THEME_OVERRIDE_STYLES }),
-    /* @__PURE__ */ jsx5(
-      BillLifecycleProgress,
-      {
-        state: data.lifecycle.state,
-        nativeStatus: data.lifecycle.nativeStatus,
-        submittedAt: data.lifecycle.submittedAt ?? null,
-        agingDays: data.lifecycle.agingDays ?? null,
-        ...appearance ? { appearance } : {}
-      }
-    ),
-    /* @__PURE__ */ jsx5(
-      BillSnapshotSummary,
-      {
-        bill: data.bill,
-        patient: data.patient,
-        injury: data.injury,
-        delivery: data.delivery,
-        ...appearance ? { appearance } : {}
-      }
-    ),
-    /* @__PURE__ */ jsx5(
-      BillStatusSummary,
-      {
-        status: data.lifecycle.state,
-        submittedAt: data.lifecycle.submittedAt ?? null,
-        agingDays: data.lifecycle.agingDays ?? null,
-        updatedAt: data.lifecycle.updatedAt ?? null,
-        totalCharge: data.bill.totalCharge,
-        totalPaid: data.bill.totalPaid,
-        balanceDue: data.bill.balanceDue,
-        actions: actionButtons,
-        ...appearance ? { appearance } : {}
-      }
-    ),
-    /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-toolbar", children: [
-      /* @__PURE__ */ jsxs5("div", { children: [
-        /* @__PURE__ */ jsxs5("strong", { children: [
-          "Bill #",
-          data.bill.billNumber
+  const viewEor = data.lifecycle.actions.find((action) => action.id === "view_eor" && action.enabled);
+  const supportedActions = /* @__PURE__ */ new Set(["second_review", "post_payment", "close", "reopen"]);
+  const actions = data.lifecycle.actions.filter((action) => action.enabled && supportedActions.has(action.id));
+  return /* @__PURE__ */ jsxs6("section", { className: ["mb-connected-lifecycle", className].filter(Boolean).join(" "), style: mindBillAppearanceStyle(appearance, style), children: [
+    /* @__PURE__ */ jsx6("style", { children: CONNECTED_LIFECYCLE_STYLES }),
+    /* @__PURE__ */ jsx6(BillLifecycleProgress, { state: data.lifecycle.state, nativeStatus: data.lifecycle.nativeStatus, submittedAt: data.lifecycle.submittedAt ?? null, agingDays: data.lifecycle.agingDays ?? null, ...appearance ? { appearance } : {} }),
+    /* @__PURE__ */ jsxs6("header", { className: "mb-lifecycle-head", children: [
+      /* @__PURE__ */ jsxs6("div", { children: [
+        /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-title", children: [
+          /* @__PURE__ */ jsxs6("h2", { children: [
+            "Bill #",
+            data.bill.billNumber
+          ] }),
+          /* @__PURE__ */ jsx6("span", { children: stateLabel(data.lifecycle.nativeStatus || data.lifecycle.state) })
         ] }),
-        /* @__PURE__ */ jsx5("span", { children: lifecycle.isRefreshing ? "Refreshing\u2026" : "Status and actions update automatically." })
+        /* @__PURE__ */ jsxs6("p", { children: [
+          "Claim ",
+          data.injury.claimNumber || "\u2014",
+          lifecycle.isRefreshing ? " \xB7 Refreshing\u2026" : ""
+        ] })
       ] }),
-      /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-toolbar-actions", children: [
-        has("view_eor") ? /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => document.getElementById(`mb-eors-${data.bill.id}`)?.scrollIntoView({ behavior: "smooth", block: "center" }), children: "View EOR" }) : null,
-        has("close") ? /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button quiet", onClick: () => selectPanel("close"), children: "Close bill" }) : null
+      /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button primary", disabled: lifecycle.isMutating, onClick: () => void lifecycle.downloadPacket().catch(() => void 0), children: "Download packet" })
+    ] }),
+    /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-tabs", role: "tablist", "aria-label": "Bill view", children: [
+      /* @__PURE__ */ jsx6("button", { type: "button", role: "tab", "aria-selected": tab === "details", onClick: () => setTab("details"), children: "Bill details" }),
+      /* @__PURE__ */ jsxs6("button", { type: "button", role: "tab", "aria-selected": tab === "history", onClick: () => setTab("history"), children: [
+        "Bill history ",
+        /* @__PURE__ */ jsx6("span", { children: data.activity.length })
       ] })
     ] }),
-    data.eors.length ? /* @__PURE__ */ jsxs5("section", { className: "mb-lifecycle-card", id: `mb-eors-${data.bill.id}`, children: [
-      /* @__PURE__ */ jsxs5("header", { children: [
-        /* @__PURE__ */ jsxs5("div", { children: [
-          /* @__PURE__ */ jsx5("h3", { children: "Explanation of Review" }),
-          /* @__PURE__ */ jsx5("p", { children: "Review the payer response and original PDF before posting payment." })
+    tab === "details" ? /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-tabpanel", role: "tabpanel", children: [
+      /* @__PURE__ */ jsx6(BillReadOnlyForm, { data, onOpenAttachment: lifecycle.openAttachment, ...appearance ? { appearance } : {} }),
+      data.eors.length ? /* @__PURE__ */ jsxs6("section", { className: "mb-lifecycle-card", id: `mb-eors-${data.bill.id}`, children: [
+        /* @__PURE__ */ jsxs6("header", { children: [
+          /* @__PURE__ */ jsxs6("div", { children: [
+            /* @__PURE__ */ jsx6("h3", { children: "Explanation of Review" }),
+            /* @__PURE__ */ jsx6("p", { children: "The payer response associated with this immutable submission." })
+          ] }),
+          /* @__PURE__ */ jsx6("span", { children: data.eors.length })
         ] }),
-        /* @__PURE__ */ jsxs5("span", { children: [
-          data.eors.length,
-          " PDF",
-          data.eors.length === 1 ? "" : "s"
+        /* @__PURE__ */ jsx6("ul", { className: "mb-lifecycle-documents", children: data.eors.map((eor) => /* @__PURE__ */ jsxs6("li", { children: [
+          /* @__PURE__ */ jsxs6("div", { children: [
+            /* @__PURE__ */ jsx6("strong", { children: eor.filename }),
+            /* @__PURE__ */ jsx6("span", { children: eor.description || `Received ${new Date(eor.addedAt).toLocaleDateString()}` })
+          ] }),
+          /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => void lifecycle.openEor(eor).catch(() => void 0), children: "View EOR" })
+        ] }, eor.id)) })
+      ] }) : null,
+      viewEor || actions.length ? /* @__PURE__ */ jsxs6("section", { className: "mb-lifecycle-actions-sheet", children: [
+        /* @__PURE__ */ jsxs6("div", { children: [
+          /* @__PURE__ */ jsx6("h3", { children: data.lifecycle.state.includes("closed") ? "This bill is closed" : data.lifecycle.state.includes("denied") || data.lifecycle.state.includes("rejected") ? "This bill needs attention" : "Available actions" }),
+          /* @__PURE__ */ jsx6("p", { children: "Actions are determined by the current bill status." })
+        ] }),
+        /* @__PURE__ */ jsxs6("div", { children: [
+          viewEor ? /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => document.getElementById(`mb-eors-${data.bill.id}`)?.scrollIntoView({ behavior: "smooth" }), children: viewEor.label }) : null,
+          actions.map((action) => /* @__PURE__ */ jsx6("button", { type: "button", className: action.primary ? "mb-lifecycle-button primary" : "mb-lifecycle-button secondary", onClick: () => {
+            const next = actionPanel(action);
+            if (next) setPanel(next);
+          }, children: action.label }, action.id))
         ] })
+      ] }) : null
+    ] }) : /* @__PURE__ */ jsx6("div", { className: "mb-lifecycle-tabpanel", role: "tabpanel", children: /* @__PURE__ */ jsx6(BillActivityTimeline, { events: data.activity, ...appearance ? { appearance } : {} }) }),
+    panel === "second_review" ? /* @__PURE__ */ jsx6(LifecycleDialog, { title: "Submit Second Review", onClose: () => setPanel(""), children: /* @__PURE__ */ jsxs6("section", { className: "mb-lifecycle-panel", children: [
+      /* @__PURE__ */ jsxs6("div", { children: [
+        /* @__PURE__ */ jsx6("h3", { children: "Submit Second Review" }),
+        /* @__PURE__ */ jsx6("p", { children: "Explain the dispute and include the payer control number and supporting documents." })
       ] }),
-      /* @__PURE__ */ jsx5("ul", { className: "mb-lifecycle-documents", children: data.eors.map((eor) => /* @__PURE__ */ jsxs5("li", { children: [
-        /* @__PURE__ */ jsxs5("div", { children: [
-          /* @__PURE__ */ jsx5("strong", { children: eor.filename }),
-          /* @__PURE__ */ jsx5("span", { children: eor.description || `Added ${new Date(eor.addedAt).toLocaleDateString()}` })
+      /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-fields two", children: [
+        /* @__PURE__ */ jsxs6("label", { className: "full", children: [
+          /* @__PURE__ */ jsx6("span", { children: "Reason" }),
+          /* @__PURE__ */ jsx6("textarea", { required: true, value: review.reason, onChange: (event) => setReview((current) => ({ ...current, reason: event.target.value })) })
         ] }),
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => void lifecycle.openEor(eor).catch(() => void 0), children: "View PDF" })
-      ] }, eor.id)) })
-    ] }) : null,
-    /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-detail-grid", children: [
-      /* @__PURE__ */ jsx5(BillRemittanceCard, { remittance: data.remittance, ...appearance ? { appearance } : {} }),
-      /* @__PURE__ */ jsx5(BillPayerContactCard, { delivery: data.delivery, ...appearance ? { appearance } : {} }),
-      /* @__PURE__ */ jsx5(BillPaymentLedger, { payments: data.payments, ...appearance ? { appearance } : {} })
-    ] }),
-    /* @__PURE__ */ jsx5(BillActivityTimeline, { events: data.activity, ...appearance ? { appearance } : {} }),
-    has("independent_bill_review") ? /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-info", children: [
-      /* @__PURE__ */ jsx5("strong", { children: has("independent_bill_review")?.label }),
-      /* @__PURE__ */ jsx5("span", { children: has("independent_bill_review")?.reason })
-    ] }) : null,
-    panel === "second_review" ? /* @__PURE__ */ jsx5(LifecycleDialog, { title: "Submit Second Review", onClose: closePanel, children: /* @__PURE__ */ jsxs5("section", { className: "mb-lifecycle-panel wide", children: [
-      /* @__PURE__ */ jsxs5("div", { children: [
-        /* @__PURE__ */ jsx5("h3", { children: "Submit Second Review" }),
-        /* @__PURE__ */ jsx5("p", { children: "State why payment is disputed, confirm the payer control number, and choose the supporting documents to send." })
-      ] }),
-      /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-fields two", children: [
-        /* @__PURE__ */ jsxs5("label", { children: [
-          /* @__PURE__ */ jsx5("span", { children: "Reason for Second Review" }),
-          /* @__PURE__ */ jsx5("textarea", { required: true, value: review.reason, onChange: (event) => setReview((current) => ({ ...current, reason: event.target.value })) })
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: "Payer claim control number" }),
+          /* @__PURE__ */ jsx6("input", { required: true, value: review.payerClaimControlNumber, onChange: (event) => setReview((current) => ({ ...current, payerClaimControlNumber: event.target.value })) })
         ] }),
-        /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-fields", children: [
-          /* @__PURE__ */ jsxs5("label", { children: [
-            /* @__PURE__ */ jsx5("span", { children: "Payer claim control number" }),
-            /* @__PURE__ */ jsx5("input", { required: true, value: review.payerClaimControlNumber, onChange: (event) => setReview((current) => ({ ...current, payerClaimControlNumber: event.target.value })) })
-          ] }),
-          /* @__PURE__ */ jsxs5("label", { children: [
-            /* @__PURE__ */ jsx5("span", { children: "Disputed amount" }),
-            /* @__PURE__ */ jsx5("input", { type: "number", min: "0.01", step: "0.01", value: review.disputedAmount ?? "", onChange: (event) => setReview((current) => ({ ...current, disputedAmount: event.target.value ? Number(event.target.value) : void 0 })) })
-          ] }),
-          /* @__PURE__ */ jsxs5("label", { children: [
-            /* @__PURE__ */ jsx5("span", { children: "Send via" }),
-            /* @__PURE__ */ jsxs5("select", { value: review.route, onChange: (event) => setReview((current) => ({ ...current, route: event.target.value })), children: [
-              /* @__PURE__ */ jsx5("option", { value: "ebill", children: "E-bill" }),
-              /* @__PURE__ */ jsx5("option", { value: "fax", children: "Fax" }),
-              /* @__PURE__ */ jsx5("option", { value: "mail", children: "Mail" }),
-              /* @__PURE__ */ jsx5("option", { value: "email", children: "Email" })
-            ] })
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: "Disputed amount" }),
+          /* @__PURE__ */ jsx6("input", { type: "number", min: "0.01", step: "0.01", value: review.disputedAmount ?? "", onChange: (event) => setReview((current) => ({ ...current, disputedAmount: event.target.value ? Number(event.target.value) : void 0 })) })
+        ] }),
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: "Send via" }),
+          /* @__PURE__ */ jsxs6("select", { value: review.route, onChange: (event) => setReview((current) => ({ ...current, route: event.target.value })), children: [
+            /* @__PURE__ */ jsx6("option", { value: "ebill", children: "E-bill" }),
+            /* @__PURE__ */ jsx6("option", { value: "fax", children: "Fax" }),
+            /* @__PURE__ */ jsx6("option", { value: "mail", children: "Mail" }),
+            /* @__PURE__ */ jsx6("option", { value: "email", children: "Email" })
           ] })
         ] })
       ] }),
-      /* @__PURE__ */ jsxs5("fieldset", { className: "mb-lifecycle-packet", children: [
-        /* @__PURE__ */ jsx5("legend", { children: "Supporting packet" }),
-        data.bill.attachments.map((attachment) => /* @__PURE__ */ jsxs5("label", { children: [
-          /* @__PURE__ */ jsx5("input", { type: "checkbox", checked: review.attachmentIds.includes(attachment.id), onChange: (event) => setReview((current) => ({ ...current, attachmentIds: event.target.checked ? [...current.attachmentIds, attachment.id] : current.attachmentIds.filter((id) => id !== attachment.id) })) }),
-          /* @__PURE__ */ jsxs5("span", { children: [
-            /* @__PURE__ */ jsx5("strong", { children: attachment.filename }),
-            /* @__PURE__ */ jsx5("small", { children: attachment.description || attachment.documentType })
+      /* @__PURE__ */ jsxs6("fieldset", { className: "mb-lifecycle-packet", children: [
+        /* @__PURE__ */ jsx6("legend", { children: "Supporting packet" }),
+        data.bill.attachments.map((attachment) => /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("input", { type: "checkbox", checked: review.attachmentIds.includes(attachment.id), onChange: (event) => setReview((current) => ({ ...current, attachmentIds: event.target.checked ? [...current.attachmentIds, attachment.id] : current.attachmentIds.filter((id) => id !== attachment.id) })) }),
+          /* @__PURE__ */ jsxs6("span", { children: [
+            /* @__PURE__ */ jsx6("strong", { children: attachment.filename }),
+            /* @__PURE__ */ jsx6("small", { children: attachment.description || attachment.documentType })
           ] }),
-          /* @__PURE__ */ jsx5("button", { type: "button", onClick: () => void lifecycle.openAttachment(attachment).catch(() => void 0), children: "View" })
+          /* @__PURE__ */ jsx6("button", { type: "button", onClick: () => void lifecycle.openAttachment(attachment).catch(() => void 0), children: "View" })
         ] }, attachment.id))
       ] }),
-      /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-panel-actions", children: [
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: closePanel, children: "Cancel" }),
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button primary", disabled: lifecycle.isMutating || !review.reason.trim() || !review.payerClaimControlNumber.trim(), onClick: () => void complete("Second Review submitted.", () => lifecycle.submitSecondReview(review)), children: lifecycle.isMutating ? "Submitting\u2026" : "Submit Second Review" })
+      /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-panel-actions", children: [
+        /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => setPanel(""), children: "Cancel" }),
+        /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button primary", disabled: lifecycle.isMutating || !review.reason.trim() || !review.payerClaimControlNumber.trim(), onClick: () => void complete("Second Review submitted.", () => lifecycle.submitSecondReview(review)), children: lifecycle.isMutating ? "Submitting\u2026" : "Submit Second Review" })
       ] })
     ] }) }) : null,
-    panel === "payment" ? /* @__PURE__ */ jsx5(LifecycleDialog, { title: "Post payment", onClose: closePanel, children: /* @__PURE__ */ jsxs5("section", { className: "mb-lifecycle-panel", children: [
-      /* @__PURE__ */ jsxs5("div", { children: [
-        /* @__PURE__ */ jsx5("h3", { children: "Post payment" }),
-        /* @__PURE__ */ jsx5("p", { children: "Record funds shown on the EOR. The balance updates and the bill closes automatically when configured." })
+    panel === "payment" ? /* @__PURE__ */ jsx6(LifecycleDialog, { title: "Post payment", onClose: () => setPanel(""), children: /* @__PURE__ */ jsxs6("section", { className: "mb-lifecycle-panel", children: [
+      /* @__PURE__ */ jsxs6("div", { children: [
+        /* @__PURE__ */ jsx6("h3", { children: "Post payment" }),
+        /* @__PURE__ */ jsx6("p", { children: "Record funds shown on the payer response." })
       ] }),
-      /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-fields two", children: [
-        /* @__PURE__ */ jsxs5("label", { children: [
-          /* @__PURE__ */ jsx5("span", { children: "Amount" }),
-          /* @__PURE__ */ jsx5("input", { type: "number", min: "0.01", max: data.bill.balanceDue, step: "0.01", required: true, value: payment.amount || "", onChange: (event) => setPayment((current) => ({ ...current, amount: Number(event.target.value) })) })
+      /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-fields two", children: [
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: "Amount" }),
+          /* @__PURE__ */ jsx6("input", { type: "number", min: "0.01", max: data.bill.balanceDue, step: "0.01", value: payment.amount || "", onChange: (event) => setPayment((current) => ({ ...current, amount: Number(event.target.value) })) })
         ] }),
-        /* @__PURE__ */ jsxs5("label", { children: [
-          /* @__PURE__ */ jsx5("span", { children: "Method" }),
-          /* @__PURE__ */ jsxs5("select", { value: payment.method, onChange: (event) => setPayment((current) => ({ ...current, method: event.target.value })), children: [
-            /* @__PURE__ */ jsx5("option", { value: "check", children: "Check" }),
-            /* @__PURE__ */ jsx5("option", { value: "eft", children: "EFT" })
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: "Method" }),
+          /* @__PURE__ */ jsxs6("select", { value: payment.method, onChange: (event) => setPayment((current) => ({ ...current, method: event.target.value })), children: [
+            /* @__PURE__ */ jsx6("option", { value: "check", children: "Check" }),
+            /* @__PURE__ */ jsx6("option", { value: "eft", children: "EFT" })
           ] })
         ] }),
-        /* @__PURE__ */ jsxs5("label", { children: [
-          /* @__PURE__ */ jsx5("span", { children: payment.method === "check" ? "Check number" : "EFT reference" }),
-          /* @__PURE__ */ jsx5("input", { value: payment.checkNumber, onChange: (event) => setPayment((current) => ({ ...current, checkNumber: event.target.value })) })
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: payment.method === "check" ? "Check number" : "EFT reference" }),
+          /* @__PURE__ */ jsx6("input", { value: payment.checkNumber, onChange: (event) => setPayment((current) => ({ ...current, checkNumber: event.target.value })) })
         ] }),
-        /* @__PURE__ */ jsxs5("label", { children: [
-          /* @__PURE__ */ jsx5("span", { children: "Deposit date" }),
-          /* @__PURE__ */ jsx5("input", { type: "date", required: true, value: payment.depositDate, onChange: (event) => setPayment((current) => ({ ...current, depositDate: event.target.value })) })
+        /* @__PURE__ */ jsxs6("label", { children: [
+          /* @__PURE__ */ jsx6("span", { children: "Deposit date" }),
+          /* @__PURE__ */ jsx6("input", { required: true, value: payment.depositDate, placeholder: "MM/DD/YYYY", onChange: (event) => setPayment((current) => ({ ...current, depositDate: event.target.value })) })
         ] }),
-        /* @__PURE__ */ jsxs5("label", { className: "full", children: [
-          /* @__PURE__ */ jsxs5("span", { children: [
-            "Note ",
-            /* @__PURE__ */ jsx5("small", { children: "Optional" })
-          ] }),
-          /* @__PURE__ */ jsx5("input", { value: payment.note, onChange: (event) => setPayment((current) => ({ ...current, note: event.target.value })) })
+        /* @__PURE__ */ jsxs6("label", { className: "full", children: [
+          /* @__PURE__ */ jsx6("span", { children: "Note (optional)" }),
+          /* @__PURE__ */ jsx6("input", { value: payment.note, onChange: (event) => setPayment((current) => ({ ...current, note: event.target.value })) })
         ] })
       ] }),
-      /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-panel-actions", children: [
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: closePanel, children: "Cancel" }),
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button primary", disabled: lifecycle.isMutating || payment.amount <= 0 || payment.amount > data.bill.balanceDue || !payment.depositDate, onClick: () => void complete("Payment posted.", () => lifecycle.postPayment(payment)), children: lifecycle.isMutating ? "Posting\u2026" : "Post payment" })
+      /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-panel-actions", children: [
+        /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => setPanel(""), children: "Cancel" }),
+        /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button primary", disabled: lifecycle.isMutating || payment.amount <= 0 || payment.amount > data.bill.balanceDue || !payment.depositDate, onClick: () => void complete("Payment posted.", () => lifecycle.postPayment(payment)), children: lifecycle.isMutating ? "Posting\u2026" : "Post payment" })
       ] })
     ] }) }) : null,
-    panel === "close" ? /* @__PURE__ */ jsx5(LifecycleDialog, { title: "Close bill", onClose: closePanel, children: /* @__PURE__ */ jsxs5("section", { className: "mb-lifecycle-panel danger", children: [
-      /* @__PURE__ */ jsxs5("div", { children: [
-        /* @__PURE__ */ jsx5("h3", { children: "Close bill" }),
-        /* @__PURE__ */ jsx5("p", { children: "Closing removes this bill from active A/R. Any remaining balance will be written off and the original lifecycle is preserved." })
+    panel === "close" || panel === "reopen" ? /* @__PURE__ */ jsx6(LifecycleDialog, { title: panel === "close" ? "Close bill" : "Reopen bill", onClose: () => setPanel(""), children: /* @__PURE__ */ jsxs6("section", { className: "mb-lifecycle-panel", children: [
+      /* @__PURE__ */ jsxs6("div", { children: [
+        /* @__PURE__ */ jsx6("h3", { children: panel === "close" ? "Close bill" : "Reopen bill" }),
+        /* @__PURE__ */ jsx6("p", { children: panel === "close" ? "The immutable submission and history remain available." : "Return this bill to active follow-up without changing the submitted snapshot." })
       ] }),
-      /* @__PURE__ */ jsxs5("label", { children: [
-        /* @__PURE__ */ jsx5("span", { children: "Reason for closing" }),
-        /* @__PURE__ */ jsx5("textarea", { required: true, value: closeReason, onChange: (event) => setCloseReason(event.target.value) })
+      /* @__PURE__ */ jsxs6("label", { children: [
+        /* @__PURE__ */ jsx6("span", { children: "Reason" }),
+        /* @__PURE__ */ jsx6("textarea", { required: true, value: reason, onChange: (event) => setReason(event.target.value) })
       ] }),
-      /* @__PURE__ */ jsxs5("div", { className: "mb-lifecycle-panel-actions", children: [
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: closePanel, children: "Cancel" }),
-        /* @__PURE__ */ jsx5("button", { type: "button", className: "mb-lifecycle-button danger", disabled: lifecycle.isMutating || !closeReason.trim(), onClick: () => void complete("Bill closed.", () => lifecycle.closeBill({ reason: closeReason })), children: lifecycle.isMutating ? "Closing\u2026" : "Close bill" })
+      /* @__PURE__ */ jsxs6("div", { className: "mb-lifecycle-panel-actions", children: [
+        /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button secondary", onClick: () => setPanel(""), children: "Cancel" }),
+        /* @__PURE__ */ jsx6("button", { type: "button", className: "mb-lifecycle-button primary", disabled: lifecycle.isMutating || !reason.trim(), onClick: () => void complete(panel === "close" ? "Bill closed." : "Bill reopened.", () => panel === "close" ? lifecycle.closeBill({ reason }) : lifecycle.reopenBill({ reason })), children: lifecycle.isMutating ? "Saving\u2026" : panel === "close" ? "Close bill" : "Reopen bill" })
       ] })
     ] }) }) : null,
-    notice ? /* @__PURE__ */ jsx5("div", { className: "mb-lifecycle-message success", role: "status", children: notice }) : null,
-    lifecycle.error ? /* @__PURE__ */ jsx5("div", { className: "mb-lifecycle-message error", role: "alert", children: lifecycle.error.message }) : null
+    notice ? /* @__PURE__ */ jsx6("div", { className: "mb-lifecycle-message success", role: "status", children: notice }) : null,
+    lifecycle.error ? /* @__PURE__ */ jsx6("div", { className: "mb-lifecycle-message error", role: "alert", children: lifecycle.error.message }) : null
   ] });
 }
 var CONNECTED_LIFECYCLE_STYLES = `
-.mb-connected-lifecycle{--mb-accent:#238dbd;--mb-text:#203743;--mb-muted:#657982;--mb-border:#dbe6ea;--mb-soft:#f3f8fa;--mb-surface:#fff;display:grid;gap:14px;color:var(--mb-text);font:14px/1.45 var(--mb-font,Inter,ui-sans-serif,system-ui,sans-serif)}.mb-connected-lifecycle *{box-sizing:border-box}.mb-lifecycle-detail-grid{display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:14px}.mb-lifecycle-detail-grid>*:last-child:nth-child(odd){grid-column:1/-1}.mb-lifecycle-toolbar{display:flex;align-items:center;justify-content:space-between;gap:16px;padding:12px 14px;border:1px solid var(--mb-border);border-radius:10px;background:var(--mb-surface)}.mb-lifecycle-toolbar>div:first-child{display:grid;gap:2px}.mb-lifecycle-toolbar span,.mb-lifecycle-card p,.mb-lifecycle-panel p,.mb-lifecycle-info span{color:var(--mb-muted)}.mb-lifecycle-toolbar-actions,.mb-lifecycle-panel-actions{display:flex;justify-content:flex-end;gap:8px}.mb-lifecycle-button{min-height:38px;border:1px solid var(--mb-border);border-radius:8px;background:#fff;color:var(--mb-text);cursor:pointer;font:inherit;font-weight:750;padding:8px 13px}.mb-lifecycle-button.primary{border-color:var(--mb-accent);background:var(--mb-accent);color:#fff}.mb-lifecycle-button.quiet{border-color:transparent;background:transparent;color:var(--mb-muted)}.mb-lifecycle-button.danger{border-color:#b63d35;background:#b63d35;color:#fff}.mb-lifecycle-button:disabled{cursor:not-allowed;opacity:.5}.mb-lifecycle-card,.mb-lifecycle-panel{padding:18px;border:1px solid var(--mb-border);border-radius:12px;background:var(--mb-surface)}.mb-lifecycle-card header{display:flex;align-items:start;justify-content:space-between;gap:16px}.mb-lifecycle-card h3,.mb-lifecycle-panel h3{margin:0;font-size:18px}.mb-lifecycle-card p,.mb-lifecycle-panel p{margin:3px 0 0}.mb-lifecycle-card header>span{padding:5px 8px;border-radius:999px;background:var(--mb-soft);color:var(--mb-muted);font-size:11px;font-weight:800;text-transform:uppercase}.mb-lifecycle-documents{list-style:none;margin:12px 0 0;padding:0}.mb-lifecycle-documents li{display:flex;align-items:center;justify-content:space-between;gap:14px;padding:11px 0;border-top:1px solid var(--mb-border)}.mb-lifecycle-documents li>div{display:grid}.mb-lifecycle-documents span{color:var(--mb-muted);font-size:12px}.mb-lifecycle-info{display:grid;gap:3px;padding:13px 15px;border:1px solid #cddfe5;border-radius:10px;background:var(--mb-soft)}.mb-lifecycle-dialog-backdrop{position:fixed;z-index:2147483000;inset:0;display:grid;place-items:center;padding:20px;background:rgba(18,35,43,.56);backdrop-filter:blur(3px)}.mb-lifecycle-dialog{position:relative;width:min(760px,100%);max-height:calc(100vh - 40px);overflow:auto;outline:0}.mb-lifecycle-dialog-close{position:absolute;z-index:1;top:12px;right:12px;width:34px;height:34px;border:1px solid var(--mb-border);border-radius:8px;background:var(--mb-surface);color:var(--mb-text);cursor:pointer;font:22px/1 inherit}.mb-lifecycle-panel{display:grid;gap:16px;padding-top:24px;box-shadow:0 24px 70px rgba(18,35,43,.22)}.mb-lifecycle-panel.danger{border-color:#ecc5c2}.mb-lifecycle-panel label{display:grid;gap:6px;font-size:12px;font-weight:750}.mb-lifecycle-panel label small{color:var(--mb-muted);font-size:inherit;font-weight:500}.mb-lifecycle-panel input,.mb-lifecycle-panel select,.mb-lifecycle-panel textarea,.mb-lifecycle-upload input,.mb-lifecycle-upload select{width:100%;min-height:42px;border:1px solid var(--mb-border);border-radius:8px;background:#fff;color:var(--mb-text);font:inherit;padding:9px 11px}.mb-lifecycle-panel textarea{min-height:100px;resize:vertical}.mb-lifecycle-fields{display:grid;gap:12px}.mb-lifecycle-fields.two{grid-template-columns:repeat(2,minmax(0,1fr))}.mb-lifecycle-fields .full{grid-column:1/-1}.mb-lifecycle-packet{display:grid;gap:0;margin:0;padding:0;border:0}.mb-lifecycle-packet legend{margin-bottom:7px;font-size:12px;font-weight:800}.mb-lifecycle-packet>label{display:grid;grid-template-columns:auto 1fr auto auto;align-items:center;gap:10px;padding:10px 2px;border-top:1px solid var(--mb-border)}.mb-lifecycle-packet>label>input{width:16px;min-height:16px}.mb-lifecycle-packet>label>span{display:grid}.mb-lifecycle-packet button{border:0;background:transparent;color:var(--mb-accent);cursor:pointer;font:inherit}.mb-lifecycle-upload{display:grid;grid-template-columns:220px 1fr auto;align-items:end;gap:10px;padding:12px;border-radius:9px;background:var(--mb-soft)}.mb-lifecycle-message,.mb-lifecycle-error,.mb-lifecycle-loading{padding:12px 14px;border-radius:9px}.mb-lifecycle-message.success{background:#edf9f2;color:#217449}.mb-lifecycle-message.error,.mb-lifecycle-error{background:#fff0ef;color:#9d3029}.mb-lifecycle-error{display:flex;align-items:center;gap:12px}.mb-lifecycle-error span{flex:1}.mb-lifecycle-error button{border:1px solid currentColor;border-radius:7px;background:transparent;color:inherit;padding:7px 10px}@media(max-width:760px){.mb-lifecycle-detail-grid{grid-template-columns:1fr}.mb-lifecycle-detail-grid>*:last-child:nth-child(odd){grid-column:auto}.mb-lifecycle-toolbar,.mb-lifecycle-card header{align-items:stretch;flex-direction:column}.mb-lifecycle-toolbar-actions,.mb-lifecycle-panel-actions{justify-content:start}.mb-lifecycle-fields.two,.mb-lifecycle-upload{grid-template-columns:1fr}.mb-lifecycle-documents li{align-items:start}.mb-lifecycle-packet>label{grid-template-columns:auto 1fr auto}.mb-lifecycle-dialog-backdrop{align-items:end;padding:0}.mb-lifecycle-dialog{max-height:92vh}.mb-lifecycle-dialog .mb-lifecycle-panel{border-radius:18px 18px 0 0}.mb-lifecycle-packet>label>button:last-child{grid-column:3}}
-`;
-var CONNECTED_THEME_OVERRIDE_STYLES = `
-.mb-connected-lifecycle{color:var(--mb-text);font-family:var(--mb-font,Inter,ui-sans-serif,system-ui,sans-serif)}
-.mb-lifecycle-toolbar,.mb-lifecycle-card,.mb-lifecycle-panel{border-color:var(--mb-border);border-radius:var(--mb-radius);background:var(--mb-surface)}
-.mb-lifecycle-panel{box-shadow:var(--mb-shadow)}
-.mb-lifecycle-toolbar span,.mb-lifecycle-card p,.mb-lifecycle-panel p,.mb-lifecycle-info span{color:var(--mb-muted)}
-.mb-lifecycle-button{border-color:var(--mb-border);border-radius:var(--mb-control-radius);background:var(--mb-input);color:var(--mb-text)}
-.mb-lifecycle-button.primary{border-color:var(--mb-accent);background:var(--mb-accent);color:var(--mb-accent-contrast)}
-.mb-lifecycle-button.primary:hover{filter:brightness(.96)}
-.mb-lifecycle-button.danger{border-color:var(--mb-danger);background:var(--mb-danger);color:white}
-.mb-lifecycle-card header>span,.mb-lifecycle-info,.mb-lifecycle-upload{background:var(--mb-soft)}
-.mb-lifecycle-info,.mb-lifecycle-panel input,.mb-lifecycle-panel select,.mb-lifecycle-panel textarea,.mb-lifecycle-upload input,.mb-lifecycle-upload select{border-color:var(--mb-border);border-radius:var(--mb-control-radius)}
-.mb-lifecycle-panel input,.mb-lifecycle-panel select,.mb-lifecycle-panel textarea,.mb-lifecycle-upload input,.mb-lifecycle-upload select{background:var(--mb-input);color:var(--mb-text)}
-.mb-lifecycle-message,.mb-lifecycle-error,.mb-lifecycle-loading,.mb-lifecycle-upload{border-radius:var(--mb-control-radius)}
-.mb-lifecycle-message.success{background:color-mix(in srgb,var(--mb-success) 10%,white);color:var(--mb-success)}
-.mb-lifecycle-message.error,.mb-lifecycle-error{background:color-mix(in srgb,var(--mb-danger) 10%,white);color:var(--mb-danger)}
+.mb-connected-lifecycle{--mb-accent:#176c70;--mb-text:#17282d;--mb-muted:#607176;--mb-border:#d7e0df;--mb-soft:#f4f7f6;--mb-surface:#fff;display:grid;gap:18px;color:var(--mb-text);font:14px/1.45 var(--mb-font,Inter,ui-sans-serif,system-ui,sans-serif)}.mb-connected-lifecycle *{box-sizing:border-box}.mb-lifecycle-head{display:flex;align-items:center;justify-content:space-between;gap:20px}.mb-lifecycle-title{display:flex;align-items:center;flex-wrap:wrap;gap:10px}.mb-lifecycle-title h2{margin:0;font-size:1.7rem}.mb-lifecycle-title span{border-radius:999px;background:var(--mb-soft);padding:5px 10px;font-weight:750}.mb-lifecycle-head p{margin:3px 0 0;color:var(--mb-muted)}.mb-lifecycle-tabs{display:grid;grid-template-columns:1fr 1fr;border:1px solid var(--mb-border);border-radius:12px;background:var(--mb-surface);padding:6px}.mb-lifecycle-tabs button{min-height:46px;border:0;border-radius:8px;background:transparent;color:var(--mb-muted);font:inherit;font-size:1rem;font-weight:750;cursor:pointer}.mb-lifecycle-tabs button[aria-selected=true]{background:var(--mb-accent);color:white}.mb-lifecycle-tabs span{display:inline-grid;place-items:center;min-width:24px;height:24px;margin-left:6px;border-radius:999px;background:rgba(127,127,127,.14);font-size:.8rem}.mb-lifecycle-tabpanel{display:grid;gap:18px}.mb-lifecycle-button{min-height:40px;border:1px solid var(--mb-border);border-radius:var(--mb-control-radius,8px);background:var(--mb-input,#fff);color:var(--mb-text);cursor:pointer;font:inherit;font-weight:750;padding:9px 14px}.mb-lifecycle-button.primary{border-color:var(--mb-accent);background:var(--mb-accent);color:var(--mb-accent-contrast,#fff)}.mb-lifecycle-button:disabled{cursor:not-allowed;opacity:.5}.mb-lifecycle-card,.mb-lifecycle-actions-sheet,.mb-lifecycle-panel{padding:20px;border:1px solid var(--mb-border);border-radius:var(--mb-radius,14px);background:var(--mb-surface)}.mb-lifecycle-card header,.mb-lifecycle-actions-sheet{display:flex;align-items:center;justify-content:space-between;gap:20px}.mb-lifecycle-card h3,.mb-lifecycle-actions-sheet h3,.mb-lifecycle-panel h3{margin:0;font-size:1.08rem}.mb-lifecycle-card p,.mb-lifecycle-actions-sheet p,.mb-lifecycle-panel p{margin:3px 0 0;color:var(--mb-muted)}.mb-lifecycle-card header>span{display:grid;place-items:center;min-width:28px;height:28px;border-radius:999px;background:var(--mb-soft);font-weight:750}.mb-lifecycle-actions-sheet>div:last-child{display:flex;flex-wrap:wrap;justify-content:flex-end;gap:8px}.mb-lifecycle-documents{list-style:none;margin:14px 0 0;padding:0}.mb-lifecycle-documents li{display:flex;align-items:center;justify-content:space-between;gap:14px;padding:12px 0;border-top:1px solid var(--mb-border)}.mb-lifecycle-documents li>div{display:grid;gap:3px;min-width:0}.mb-lifecycle-documents li span{color:var(--mb-muted);font-size:.85rem}.mb-lifecycle-dialog-backdrop{position:fixed;z-index:2147483000;inset:0;display:grid;place-items:center;padding:20px;background:rgba(18,35,43,.56);backdrop-filter:blur(3px)}.mb-lifecycle-dialog{position:relative;width:min(760px,100%);max-height:calc(100vh - 40px);overflow:auto;outline:0}.mb-lifecycle-dialog-close{position:absolute;z-index:1;top:12px;right:12px;width:34px;height:34px;border:1px solid var(--mb-border);border-radius:8px;background:var(--mb-surface);color:var(--mb-text);cursor:pointer;font:22px/1 inherit}.mb-lifecycle-panel{display:grid;gap:17px;padding-top:24px;box-shadow:0 24px 70px rgba(18,35,43,.22)}.mb-lifecycle-panel label{display:grid;gap:6px;font-size:.85rem;font-weight:750}.mb-lifecycle-panel label small{color:var(--mb-muted);font-weight:500}.mb-lifecycle-panel input,.mb-lifecycle-panel select,.mb-lifecycle-panel textarea{width:100%;min-height:44px;border:1px solid var(--mb-border);border-radius:var(--mb-control-radius,8px);background:var(--mb-input,#fff);color:var(--mb-text);font:inherit;padding:10px 12px}.mb-lifecycle-panel textarea{min-height:100px;resize:vertical}.mb-lifecycle-fields{display:grid;gap:13px}.mb-lifecycle-fields.two{grid-template-columns:repeat(2,minmax(0,1fr))}.mb-lifecycle-fields .full{grid-column:1/-1}.mb-lifecycle-panel-actions{display:flex;justify-content:flex-end;gap:8px}.mb-lifecycle-packet{display:grid;gap:0;margin:0;padding:0;border:0}.mb-lifecycle-packet legend{margin-bottom:7px;font-size:.85rem;font-weight:800}.mb-lifecycle-packet>label{display:grid;grid-template-columns:auto 1fr auto;align-items:center;gap:10px;padding:10px 2px;border-top:1px solid var(--mb-border)}.mb-lifecycle-packet>label>input{width:16px;min-height:16px}.mb-lifecycle-packet>label>span{display:grid}.mb-lifecycle-packet button{border:0;background:transparent;color:var(--mb-accent);cursor:pointer;font:inherit}.mb-lifecycle-message,.mb-lifecycle-error,.mb-lifecycle-loading{padding:12px 14px;border-radius:9px}.mb-lifecycle-message.success{background:#edf9f2;color:#217449}.mb-lifecycle-message.error,.mb-lifecycle-error{background:#fff0ef;color:#9d3029}.mb-lifecycle-error{display:flex;align-items:center;gap:12px}.mb-lifecycle-error span{flex:1}.mb-lifecycle-error button{border:1px solid currentColor;border-radius:7px;background:transparent;color:inherit;padding:7px 10px}
+@media(max-width:700px){.mb-lifecycle-head,.mb-lifecycle-actions-sheet,.mb-lifecycle-card header{align-items:stretch;flex-direction:column}.mb-lifecycle-head>.mb-lifecycle-button{width:100%}.mb-lifecycle-actions-sheet>div:last-child{justify-content:stretch}.mb-lifecycle-actions-sheet .mb-lifecycle-button{width:100%}.mb-lifecycle-fields.two{grid-template-columns:1fr}.mb-lifecycle-fields .full{grid-column:auto}.mb-lifecycle-dialog-backdrop{align-items:end;padding:0}.mb-lifecycle-dialog{max-height:92vh}.mb-lifecycle-dialog .mb-lifecycle-panel{border-radius:18px 18px 0 0}.mb-lifecycle-tabs button{font-size:.9rem}.mb-lifecycle-title h2{font-size:1.4rem}}
 `;
 
 // src/index.tsx
 function widget(tagName, props) {
-  const ref = useRef4(null);
+  const ref = useRef5(null);
   const { onMindBill, onMindBillError } = props;
   useEffect5(() => {
     const element = ref.current;
@@ -2517,6 +2588,7 @@ export {
   BillLifecycleProgress,
   BillPayerContactCard,
   BillPaymentLedger,
+  BillReadOnlyForm,
   BillRemittanceCard,
   BillReviewForm,
   BillSnapshotSummary,
@@ -2526,14 +2598,18 @@ export {
   ConnectedBillStatus,
   MindBillBillReview,
   MindBillBillTimeline,
+  applyBillSubmissionEvaluationModifiers,
   billActivityEventLabel,
   billLifecycleStage,
   buildBillReviewSaveInput,
   createBillLifecycleClient2 as createBillLifecycleClient,
   createBillStatusClient,
+  ensureTrailingBillSubmissionLine,
   ensureTrailingProcedureLine,
+  formatBillSubmissionDate,
   mindBillAppearanceStyle,
   mindBillThemePresets,
+  parseBillSubmissionDate,
   resolveMindBillAppearance,
   useBillLifecycle,
   useBillStatus,