@unite-us/app-create-referral 0.15.62 → 0.15.63

package/dist/pages/builder/AboutGroupedReferralsModal.js

@@ -1,9 +1,12 @@
 import React from 'react';
 import { Modal, Button } from '@unite-us/app-components';
 import { ON_PLATFORM_REFERRALS, OFF_PLATFORM_REFERRALS, GROUPED_REFERRALS_EXPLANATION, UNGROUP_REFERRAL_EXPLANATION, GROUPED_REFERRAL_MUST_HAVE_SAME } from './constants';
-var AboutGroupedReferralsModal = /*#__PURE__*/React.forwardRef(function (_ref, ref) {
-  var onClose = _ref.onClose;
-  return /*#__PURE__*/React.createElement(Modal, {
+import { jsx as _jsx, jsxs as _jsxs } from "react/jsx-runtime";
+const AboutGroupedReferralsModal = /*#__PURE__*/React.forwardRef((_ref, ref) => {
+  let {
+    onClose
+  } = _ref;
+  return /*#__PURE__*/_jsx(Modal, {
     ref: ref,
     title: "Learn more about referrals",
     customSize: {
@@ -21,30 +24,48 @@ var AboutGroupedReferralsModal = /*#__PURE__*/React.forwardRef(function (_ref, r
       left: '50%'
     },
     onRequestClose: onClose,
-    actions: /*#__PURE__*/React.createElement("div", {
-      className: "confirmation-dialog__actions"
-    }, /*#__PURE__*/React.createElement("span", {
-      className: "mr-4 inline-block"
-    }, /*#__PURE__*/React.createElement(Button, {
-      label: "Close",
-      primary: true,
-      onClick: onClose
-    })))
-  }, /*#__PURE__*/React.createElement("div", {
-    className: "min-h-full"
-  }, /*#__PURE__*/React.createElement("div", null, /*#__PURE__*/React.createElement("label", null, "On-Platform Referrals"), /*#__PURE__*/React.createElement("p", {
-    className: "text-base mb-4 mt-2 font-regular-font"
-  }, ON_PLATFORM_REFERRALS)), /*#__PURE__*/React.createElement("div", null, /*#__PURE__*/React.createElement("label", null, "Off-Platform Referrals"), /*#__PURE__*/React.createElement("p", {
-    className: "text-base mb-4 mt-2 font-regular-font"
-  }, OFF_PLATFORM_REFERRALS)), /*#__PURE__*/React.createElement("div", null, /*#__PURE__*/React.createElement("label", null, "Grouped Referrals"), /*#__PURE__*/React.createElement("p", {
-    className: "text-base mb-4 mt-2 font-regular-font"
-  }, GROUPED_REFERRALS_EXPLANATION), /*#__PURE__*/React.createElement("div", {
-    className: "grid grid-cols-2 gap-4 m-4"
-  }, GROUPED_REFERRAL_MUST_HAVE_SAME.map(function (item) {
-    return /*#__PURE__*/React.createElement("li", {
-      key: item
-    }, item);
-  })), UNGROUP_REFERRAL_EXPLANATION)));
+    actions: /*#__PURE__*/_jsx("div", {
+      className: "confirmation-dialog__actions",
+      children: /*#__PURE__*/_jsx("span", {
+        className: "mr-4 inline-block",
+        children: /*#__PURE__*/_jsx(Button, {
+          label: "Close",
+          primary: true,
+          onClick: onClose
+        })
+      })
+    }),
+    children: /*#__PURE__*/_jsxs("div", {
+      className: "min-h-full",
+      children: [/*#__PURE__*/_jsxs("div", {
+        children: [/*#__PURE__*/_jsx("label", {
+          children: "On-Platform Referrals"
+        }), /*#__PURE__*/_jsx("p", {
+          className: "text-base mb-4 mt-2 font-regular-font",
+          children: ON_PLATFORM_REFERRALS
+        })]
+      }), /*#__PURE__*/_jsxs("div", {
+        children: [/*#__PURE__*/_jsx("label", {
+          children: "Off-Platform Referrals"
+        }), /*#__PURE__*/_jsx("p", {
+          className: "text-base mb-4 mt-2 font-regular-font",
+          children: OFF_PLATFORM_REFERRALS
+        })]
+      }), /*#__PURE__*/_jsxs("div", {
+        children: [/*#__PURE__*/_jsx("label", {
+          children: "Grouped Referrals"
+        }), /*#__PURE__*/_jsx("p", {
+          className: "text-base mb-4 mt-2 font-regular-font",
+          children: GROUPED_REFERRALS_EXPLANATION
+        }), /*#__PURE__*/_jsx("div", {
+          className: "grid grid-cols-2 gap-4 m-4",
+          children: GROUPED_REFERRAL_MUST_HAVE_SAME.map(item => /*#__PURE__*/_jsx("li", {
+            children: item
+          }, item))
+        }), UNGROUP_REFERRAL_EXPLANATION]
+      })]
+    })
+  });
 });
 export default AboutGroupedReferralsModal;
 //# sourceMappingURL=AboutGroupedReferralsModal.js.map

package/dist/pages/builder/AboutGroupedReferralsModal.js.map

@@ -1 +1 @@
-{"version":3,"file":"AboutGroupedReferralsModal.js","names":["React","Modal","Button","ON_PLATFORM_REFERRALS","OFF_PLATFORM_REFERRALS","GROUPED_REFERRALS_EXPLANATION","UNGROUP_REFERRAL_EXPLANATION","GROUPED_REFERRAL_MUST_HAVE_SAME","AboutGroupedReferralsModal","forwardRef","_ref","ref","onClose","createElement","title","customSize","width","customStyle","transform","titleStyles","modal","showBorderRadius","modalContentStyles","position","top","left","onRequestClose","actions","className","label","primary","onClick","map","item","key"],"sources":["../../../src/pages/builder/AboutGroupedReferralsModal.js"],"sourcesContent":["import React from 'react';\nimport { Modal, Button } from '@unite-us/app-components';\nimport {\n  ON_PLATFORM_REFERRALS,\n  OFF_PLATFORM_REFERRALS,\n  GROUPED_REFERRALS_EXPLANATION,\n  UNGROUP_REFERRAL_EXPLANATION,\n  GROUPED_REFERRAL_MUST_HAVE_SAME\n} from './constants';\n\nconst AboutGroupedReferralsModal = React.forwardRef(({ onClose }, ref) => (\n  <Modal\n    ref={ref}\n    title=\"Learn more about referrals\"\n    customSize={{\n      width: '800px',\n    }}\n    customStyle={{\n      transform: 'translate3d(-50%, -50%, 0px)',\n    }}\n    titleStyles={'title'}\n    modal\n    showBorderRadius\n    modalContentStyles={{\n      position: 'fixed',\n      top: '50%',\n      left: '50%',\n    }}\n    onRequestClose={onClose}\n    actions={(\n      <div className=\"confirmation-dialog__actions\">\n        <span className=\"mr-4 inline-block\">\n          <Button\n            label=\"Close\"\n            primary\n            onClick={onClose}\n          />\n        </span>\n      </div>\n    )}\n  >\n    <div className='min-h-full'>\n      <div>\n        <label>On-Platform Referrals</label>\n        <p className='text-base mb-4 mt-2 font-regular-font'>\n          {ON_PLATFORM_REFERRALS}\n        </p>\n      </div>\n      <div>\n        <label>Off-Platform Referrals</label>\n        <p className='text-base mb-4 mt-2 font-regular-font'>\n          {OFF_PLATFORM_REFERRALS}\n        </p>\n      </div>\n      <div>\n        <label>Grouped Referrals</label>\n        <p className='text-base mb-4 mt-2 font-regular-font'>\n          {GROUPED_REFERRALS_EXPLANATION}\n        </p>\n        <div className='grid grid-cols-2 gap-4 m-4'>\n          {GROUPED_REFERRAL_MUST_HAVE_SAME.map((item) => (\n            <li key={item}>{item}</li>\n          ))}\n        </div>\n        {UNGROUP_REFERRAL_EXPLANATION}\n      </div>\n    </div>\n  </Modal>\n));\n\nexport default AboutGroupedReferralsModal;\n"],"mappings":"AAAA,OAAOA,KAAK,MAAM,OAAO;AACzB,SAASC,KAAK,EAAEC,MAAM,QAAQ,0BAA0B;AACxD,SACEC,qBAAqB,EACrBC,sBAAsB,EACtBC,6BAA6B,EAC7BC,4BAA4B,EAC5BC,+BAA+B,QAC1B,aAAa;AAEpB,IAAMC,0BAA0B,gBAAGR,KAAK,CAACS,UAAU,CAAC,UAAAC,IAAA,EAAcC,GAAG;EAAA,IAAdC,OAAO,GAAAF,IAAA,CAAPE,OAAO;EAAA,oBAC5DZ,KAAA,CAAAa,aAAA,CAACZ,KAAK;IACJU,GAAG,EAAEA,GAAI;IACTG,KAAK,EAAC,4BAA4B;IAClCC,UAAU,EAAE;MACVC,KAAK,EAAE;IACT,CAAE;IACFC,WAAW,EAAE;MACXC,SAAS,EAAE;IACb,CAAE;IACFC,WAAW,EAAE,OAAQ;IACrBC,KAAK;IACLC,gBAAgB;IAChBC,kBAAkB,EAAE;MAClBC,QAAQ,EAAE,OAAO;MACjBC,GAAG,EAAE,KAAK;MACVC,IAAI,EAAE;IACR,CAAE;IACFC,cAAc,EAAEd,OAAQ;IACxBe,OAAO,eACL3B,KAAA,CAAAa,aAAA;MAAKe,SAAS,EAAC;IAA8B,gBAC3C5B,KAAA,CAAAa,aAAA;MAAMe,SAAS,EAAC;IAAmB,gBACjC5B,KAAA,CAAAa,aAAA,CAACX,MAAM;MACL2B,KAAK,EAAC,OAAO;MACbC,OAAO;MACPC,OAAO,EAAEnB;IAAQ,CAClB,CACG,CACH;EACL,gBAEFZ,KAAA,CAAAa,aAAA;IAAKe,SAAS,EAAC;EAAY,gBACzB5B,KAAA,CAAAa,aAAA,2BACEb,KAAA,CAAAa,aAAA,gBAAO,uBAA4B,CAAC,eACpCb,KAAA,CAAAa,aAAA;IAAGe,SAAS,EAAC;EAAuC,GACjDzB,qBACA,CACA,CAAC,eACNH,KAAA,CAAAa,aAAA,2BACEb,KAAA,CAAAa,aAAA,gBAAO,wBAA6B,CAAC,eACrCb,KAAA,CAAAa,aAAA;IAAGe,SAAS,EAAC;EAAuC,GACjDxB,sBACA,CACA,CAAC,eACNJ,KAAA,CAAAa,aAAA,2BACEb,KAAA,CAAAa,aAAA,gBAAO,mBAAwB,CAAC,eAChCb,KAAA,CAAAa,aAAA;IAAGe,SAAS,EAAC;EAAuC,GACjDvB,6BACA,CAAC,eACJL,KAAA,CAAAa,aAAA;IAAKe,SAAS,EAAC;EAA4B,GACxCrB,+BAA+B,CAACyB,GAAG,CAAC,UAACC,IAAI;IAAA,oBACxCjC,KAAA,CAAAa,aAAA;MAAIqB,GAAG,EAAED;IAAK,GAAEA,IAAS,CAAC;EAAA,CAC3B,CACE,CAAC,EACL3B,4BACE,CACF,CACA,CAAC;AAAA,CACT,CAAC;AAEF,eAAeE,0BAA0B","ignoreList":[]}
+{"version":3,"file":"AboutGroupedReferralsModal.js","names":["React","Modal","Button","ON_PLATFORM_REFERRALS","OFF_PLATFORM_REFERRALS","GROUPED_REFERRALS_EXPLANATION","UNGROUP_REFERRAL_EXPLANATION","GROUPED_REFERRAL_MUST_HAVE_SAME","jsx","_jsx","jsxs","_jsxs","AboutGroupedReferralsModal","forwardRef","_ref","ref","onClose","title","customSize","width","customStyle","transform","titleStyles","modal","showBorderRadius","modalContentStyles","position","top","left","onRequestClose","actions","className","children","label","primary","onClick","map","item"],"sources":["../../../src/pages/builder/AboutGroupedReferralsModal.js"],"sourcesContent":["import React from 'react';\nimport { Modal, Button } from '@unite-us/app-components';\nimport {\n  ON_PLATFORM_REFERRALS,\n  OFF_PLATFORM_REFERRALS,\n  GROUPED_REFERRALS_EXPLANATION,\n  UNGROUP_REFERRAL_EXPLANATION,\n  GROUPED_REFERRAL_MUST_HAVE_SAME\n} from './constants';\n\nconst AboutGroupedReferralsModal = React.forwardRef(({ onClose }, ref) => (\n  <Modal\n    ref={ref}\n    title=\"Learn more about referrals\"\n    customSize={{\n      width: '800px',\n    }}\n    customStyle={{\n      transform: 'translate3d(-50%, -50%, 0px)',\n    }}\n    titleStyles={'title'}\n    modal\n    showBorderRadius\n    modalContentStyles={{\n      position: 'fixed',\n      top: '50%',\n      left: '50%',\n    }}\n    onRequestClose={onClose}\n    actions={(\n      <div className=\"confirmation-dialog__actions\">\n        <span className=\"mr-4 inline-block\">\n          <Button\n            label=\"Close\"\n            primary\n            onClick={onClose}\n          />\n        </span>\n      </div>\n    )}\n  >\n    <div className='min-h-full'>\n      <div>\n        <label>On-Platform Referrals</label>\n        <p className='text-base mb-4 mt-2 font-regular-font'>\n          {ON_PLATFORM_REFERRALS}\n        </p>\n      </div>\n      <div>\n        <label>Off-Platform Referrals</label>\n        <p className='text-base mb-4 mt-2 font-regular-font'>\n          {OFF_PLATFORM_REFERRALS}\n        </p>\n      </div>\n      <div>\n        <label>Grouped Referrals</label>\n        <p className='text-base mb-4 mt-2 font-regular-font'>\n          {GROUPED_REFERRALS_EXPLANATION}\n        </p>\n        <div className='grid grid-cols-2 gap-4 m-4'>\n          {GROUPED_REFERRAL_MUST_HAVE_SAME.map((item) => (\n            <li key={item}>{item}</li>\n          ))}\n        </div>\n        {UNGROUP_REFERRAL_EXPLANATION}\n      </div>\n    </div>\n  </Modal>\n));\n\nexport default AboutGroupedReferralsModal;\n"],"mappings":"AAAA,OAAOA,KAAK,MAAM,OAAO;AACzB,SAASC,KAAK,EAAEC,MAAM,QAAQ,0BAA0B;AACxD,SACEC,qBAAqB,EACrBC,sBAAsB,EACtBC,6BAA6B,EAC7BC,4BAA4B,EAC5BC,+BAA+B,QAC1B,aAAa;AAAC,SAAAC,GAAA,IAAAC,IAAA,EAAAC,IAAA,IAAAC,KAAA;AAErB,MAAMC,0BAA0B,gBAAGZ,KAAK,CAACa,UAAU,CAAC,CAAAC,IAAA,EAAcC,GAAG;EAAA,IAAhB;IAAEC;EAAQ,CAAC,GAAAF,IAAA;EAAA,oBAC9DL,IAAA,CAACR,KAAK;IACJc,GAAG,EAAEA,GAAI;IACTE,KAAK,EAAC,4BAA4B;IAClCC,UAAU,EAAE;MACVC,KAAK,EAAE;IACT,CAAE;IACFC,WAAW,EAAE;MACXC,SAAS,EAAE;IACb,CAAE;IACFC,WAAW,EAAE,OAAQ;IACrBC,KAAK;IACLC,gBAAgB;IAChBC,kBAAkB,EAAE;MAClBC,QAAQ,EAAE,OAAO;MACjBC,GAAG,EAAE,KAAK;MACVC,IAAI,EAAE;IACR,CAAE;IACFC,cAAc,EAAEb,OAAQ;IACxBc,OAAO,eACLrB,IAAA;MAAKsB,SAAS,EAAC,8BAA8B;MAAAC,QAAA,eAC3CvB,IAAA;QAAMsB,SAAS,EAAC,mBAAmB;QAAAC,QAAA,eACjCvB,IAAA,CAACP,MAAM;UACL+B,KAAK,EAAC,OAAO;UACbC,OAAO;UACPC,OAAO,EAAEnB;QAAQ,CAClB;MAAC,CACE;IAAC,CACJ,CACL;IAAAgB,QAAA,eAEFrB,KAAA;MAAKoB,SAAS,EAAC,YAAY;MAAAC,QAAA,gBACzBrB,KAAA;QAAAqB,QAAA,gBACEvB,IAAA;UAAAuB,QAAA,EAAO;QAAqB,CAAO,CAAC,eACpCvB,IAAA;UAAGsB,SAAS,EAAC,uCAAuC;UAAAC,QAAA,EACjD7B;QAAqB,CACrB,CAAC;MAAA,CACD,CAAC,eACNQ,KAAA;QAAAqB,QAAA,gBACEvB,IAAA;UAAAuB,QAAA,EAAO;QAAsB,CAAO,CAAC,eACrCvB,IAAA;UAAGsB,SAAS,EAAC,uCAAuC;UAAAC,QAAA,EACjD5B;QAAsB,CACtB,CAAC;MAAA,CACD,CAAC,eACNO,KAAA;QAAAqB,QAAA,gBACEvB,IAAA;UAAAuB,QAAA,EAAO;QAAiB,CAAO,CAAC,eAChCvB,IAAA;UAAGsB,SAAS,EAAC,uCAAuC;UAAAC,QAAA,EACjD3B;QAA6B,CAC7B,CAAC,eACJI,IAAA;UAAKsB,SAAS,EAAC,4BAA4B;UAAAC,QAAA,EACxCzB,+BAA+B,CAAC6B,GAAG,CAAEC,IAAI,iBACxC5B,IAAA;YAAAuB,QAAA,EAAgBK;UAAI,GAAXA,IAAgB,CAC1B;QAAC,CACC,CAAC,EACL/B,4BAA4B;MAAA,CAC1B,CAAC;IAAA,CACH;EAAC,CACD,CAAC;AAAA,CACT,CAAC;AAEF,eAAeM,0BAA0B","ignoreList":[]}

package/dist/pages/builder/AuthorizationSubform.js

@@ -1,10 +1,6 @@
-function _slicedToArray(r, e) { return _arrayWithHoles(r) || _iterableToArrayLimit(r, e) || _unsupportedIterableToArray(r, e) || _nonIterableRest(); }
-function _nonIterableRest() { throw new TypeError("Invalid attempt to destructure non-iterable instance.\nIn order to be iterable, non-array objects must have a [Symbol.iterator]() method."); }
-function _unsupportedIterableToArray(r, a) { if (r) { if ("string" == typeof r) return _arrayLikeToArray(r, a); var t = {}.toString.call(r).slice(8, -1); return "Object" === t && r.constructor && (t = r.constructor.name), "Map" === t || "Set" === t ? Array.from(r) : "Arguments" === t || /^(?:Ui|I)nt(?:8|16|32)(?:Clamped)?Array$/.test(t) ? _arrayLikeToArray(r, a) : void 0; } }
-function _arrayLikeToArray(r, a) { (null == a || a > r.length) && (a = r.length); for (var e = 0, n = Array(a); e < a; e++) n[e] = r[e]; return n; }
-function _iterableToArrayLimit(r, l) { var t = null == r ? null : "undefined" != typeof Symbol && r[Symbol.iterator] || r["@@iterator"]; if (null != t) { var e, n, i, u, a = [], f = !0, o = !1; try { if (i = (t = t.call(r)).next, 0 === l) { if (Object(t) !== t) return; f = !1; } else for (; !(f = (e = i.call(t)).done) && (a.push(e.value), a.length !== l); f = !0); } catch (r) { o = !0, n = r; } finally { try { if (!f && null != t.return && (u = t.return(), Object(u) !== u)) return; } finally { if (o) throw n; } } return a; } }
-function _arrayWithHoles(r) { if (Array.isArray(r)) return r; }
-function _extends() { return _extends = Object.assign ? Object.assign.bind() : function (n) { for (var e = 1; e < arguments.length; e++) { var t = arguments[e]; for (var r in t) ({}).hasOwnProperty.call(t, r) && (n[r] = t[r]); } return n; }, _extends.apply(null, arguments); }
+import _defineProperty from "@babel/runtime/helpers/defineProperty";
+function ownKeys(e, r) { var t = Object.keys(e); if (Object.getOwnPropertySymbols) { var o = Object.getOwnPropertySymbols(e); r && (o = o.filter(function (r) { return Object.getOwnPropertyDescriptor(e, r).enumerable; })), t.push.apply(t, o); } return t; }
+function _objectSpread(e) { for (var r = 1; r < arguments.length; r++) { var t = null != arguments[r] ? arguments[r] : {}; r % 2 ? ownKeys(Object(t), !0).forEach(function (r) { _defineProperty(e, r, t[r]); }) : Object.getOwnPropertyDescriptors ? Object.defineProperties(e, Object.getOwnPropertyDescriptors(t)) : ownKeys(Object(t)).forEach(function (r) { Object.defineProperty(e, r, Object.getOwnPropertyDescriptor(t, r)); }); } return e; }
 import React, { useState } from 'react';
 import PropTypes from 'prop-types';
 import { Field } from 'react-final-form';
@@ -18,131 +14,147 @@ import CurrencyField from '../../common/form/CurrencyField';
 import DollarAmount from '../../components/DollarAmount';
 import useClinicalModificationOptions from '../../hooks/useClinicalModificationOptions';
 import LineItem from './LineItem';
-var AuthFormLineItem = function AuthFormLineItem(props) {
-  return /*#__PURE__*/React.createElement(LineItem, _extends({
-    fieldClassName: "col-span-1 p-0 text-dark-grey",
-    valueClassName: "col-span-2 m-0 p-0 text-dark-blue"
-  }, props));
-};
-var AuthorizationSubform = function AuthorizationSubform(_ref) {
+import { jsx as _jsx, jsxs as _jsxs, Fragment as _Fragment } from "react/jsx-runtime";
+const AuthFormLineItem = props => /*#__PURE__*/_jsx(LineItem, _objectSpread({
+  fieldClassName: "col-span-1 p-0 text-dark-grey",
+  valueClassName: "col-span-2 m-0 p-0 text-dark-blue"
+}, props));
+const AuthorizationSubform = _ref => {
   var _formValues$paymentAu, _formValues$paymentAu2, _formValues$amount_re;
-  var feeScheduleProgram = _ref.feeScheduleProgram,
-    formValues = _ref.formValues,
-    setReferralErrors = _ref.setReferralErrors;
-  var isCostBased = fspUtils.isCostPaymentType(feeScheduleProgram.payment_type);
-  var showUnits = !isCostBased && (feeScheduleProgram === null || feeScheduleProgram === void 0 ? void 0 : feeScheduleProgram.unit);
-  var showRate = showUnits && (feeScheduleProgram === null || feeScheduleProgram === void 0 ? void 0 : feeScheduleProgram.unit_rate) > 0;
-  var hasDatesSelected = !!(formValues !== null && formValues !== void 0 && (_formValues$paymentAu = formValues.paymentAuthForm) !== null && _formValues$paymentAu !== void 0 && _formValues$paymentAu.service_start && formValues !== null && formValues !== void 0 && (_formValues$paymentAu2 = formValues.paymentAuthForm) !== null && _formValues$paymentAu2 !== void 0 && _formValues$paymentAu2.service_end);
-  var _useState = useState(undefined),
-    _useState2 = _slicedToArray(_useState, 2),
-    icdSearchQuery = _useState2[0],
-    setIcdSearchQuery = _useState2[1];
-  var icdOptions = useClinicalModificationOptions(icdSearchQuery);
-  return /*#__PURE__*/React.createElement(React.Fragment, null, /*#__PURE__*/React.createElement("div", {
-    className: "space-y-6"
-  }, /*#__PURE__*/React.createElement("h5", {
-    className: "text-sm ui-form-field__label m-0"
-  }, "AUTHORIZATION REQUEST"), /*#__PURE__*/React.createElement("dl", {
-    className: "grid grid-cols-3 gap-x-6 gap-y-2"
-  }, /*#__PURE__*/React.createElement(AuthFormLineItem, {
-    field: "Contracted Program"
-  }, feeScheduleProgram.name), /*#__PURE__*/React.createElement(AuthFormLineItem, {
-    field: "Payment Approach"
-  }, fspUtils.PAYMENT_TYPES[feeScheduleProgram.payment_type] || 'N/A'), showUnits && /*#__PURE__*/React.createElement(AuthFormLineItem, {
-    field: "Unit"
-  }, feeScheduleProgram.unit), showRate && /*#__PURE__*/React.createElement(AuthFormLineItem, {
-    field: "Rate"
-  }, /*#__PURE__*/React.createElement(DollarAmount, {
-    value: feeScheduleProgram.unit_rate,
-    convertCents: true
-  }), ' per ', feeScheduleProgram.unit), /*#__PURE__*/React.createElement(AuthFormLineItem, {
-    field: "Program Cap"
-  }, feeScheduleProgram.cap_information ? /*#__PURE__*/React.createElement("div", {
-    dangerouslySetInnerHTML: {
-      __html: feeScheduleProgram.cap_information
-    }
-  }) : 'No cap')), /*#__PURE__*/React.createElement("hr", {
-    className: "p-0"
-  }), /*#__PURE__*/React.createElement("div", {
-    className: "grid grid-cols-3 gap-x-6 gap-y-3"
-  }, /*#__PURE__*/React.createElement(Field, {
-    name: "paymentAuthForm.amount_requested"
-  }, function (params) {
-    return isCostBased ? /*#__PURE__*/React.createElement(CurrencyField, _extends({
-      className: "col-span-1 px-0",
-      id: "authorization-request-amount-requested",
-      label: "Amount Requested",
-      required: true
-    }, params)) : /*#__PURE__*/React.createElement(InputField, _extends({
-      className: "col-span-1 px-0",
-      id: "authorization-request-amount-requested",
-      label: "Amount Requested",
-      type: "number",
-      required: true
-    }, params));
-  }), /*#__PURE__*/React.createElement("div", {
-    className: "col-span-2 p-0 space-y-2"
-  }, /*#__PURE__*/React.createElement("div", {
-    className: "font-heavy-font text-dark-grey"
-  }, "Unit"), /*#__PURE__*/React.createElement("div", {
-    className: "capitalize"
-  }, isCostBased ? 'Dollars' : pluralize(feeScheduleProgram.unit || '', (formValues === null || formValues === void 0 || (_formValues$amount_re = formValues.amount_requested) === null || _formValues$amount_re === void 0 ? void 0 : _formValues$amount_re.value) || 0))), /*#__PURE__*/React.createElement("div", {
-    className: "col-span-1 p-0 m-0"
-  }, /*#__PURE__*/React.createElement(Field, {
-    name: "paymentAuthForm.service_start"
-  }, function (startProps) {
-    return /*#__PURE__*/React.createElement(Field, {
-      name: "paymentAuthForm.service_end"
-    }, function (endProps) {
-      return /*#__PURE__*/React.createElement(DurationField, {
-        id: "authorization-request-service-dates",
-        label: "Service Delivery Date(s)",
-        startField: startProps,
-        startFieldPath: "startField",
-        endField: endProps,
-        endFieldPath: "endField",
-        required: true,
-        style: {
-          container: {
-            width: 'unset'
-          }
-        }
-      });
-    });
-  })), feeScheduleProgram.cm_code_required_on_authorization && /*#__PURE__*/React.createElement(React.Fragment, null, /*#__PURE__*/React.createElement("div", {
-    className: "col-span-1 p-0 m-0 mb-8 row-start-4",
-    "data-testid": "icd10-dropdown"
-  }, /*#__PURE__*/React.createElement(Field, {
-    name: "paymentAuthForm.icd10_code"
-  }, function (params) {
-    var onSelectionChange = function onSelectionChange(newVal) {
-      params.input.onChange(newVal);
-      setIcdSearchQuery(newVal.label);
-    };
-    var onInputChange = function onInputChange(value) {
-      setIcdSearchQuery(value);
-      params.input.onChange('');
-    };
-    return /*#__PURE__*/React.createElement(SearchableField, _extends({
-      className: "",
-      id: "authorization-request-icd10-code",
-      label: "ICD-10 Code",
-      labelClassName: "tracking-normal",
-      onChange: onSelectionChange,
-      options: icdOptions,
-      onInputChange: onInputChange,
-      placeholder: "Select an ICD-10 code",
-      clearable: true,
-      required: true
-    }, params));
-  }))))), hasDatesSelected && /*#__PURE__*/React.createElement(React.Fragment, null, /*#__PURE__*/React.createElement("hr", {
-    className: "mb-6"
-  }), /*#__PURE__*/React.createElement(CapsInfo, {
-    feeScheduleProgram: feeScheduleProgram,
-    formValues: formValues,
-    isCostBased: isCostBased,
-    setReferralErrors: setReferralErrors
-  })));
+  let {
+    feeScheduleProgram,
+    formValues,
+    setReferralErrors
+  } = _ref;
+  const isCostBased = fspUtils.isCostPaymentType(feeScheduleProgram.payment_type);
+  const showUnits = !isCostBased && (feeScheduleProgram === null || feeScheduleProgram === void 0 ? void 0 : feeScheduleProgram.unit);
+  const showRate = showUnits && (feeScheduleProgram === null || feeScheduleProgram === void 0 ? void 0 : feeScheduleProgram.unit_rate) > 0;
+  const hasDatesSelected = !!(formValues !== null && formValues !== void 0 && (_formValues$paymentAu = formValues.paymentAuthForm) !== null && _formValues$paymentAu !== void 0 && _formValues$paymentAu.service_start && formValues !== null && formValues !== void 0 && (_formValues$paymentAu2 = formValues.paymentAuthForm) !== null && _formValues$paymentAu2 !== void 0 && _formValues$paymentAu2.service_end);
+  const [icdSearchQuery, setIcdSearchQuery] = useState(undefined);
+  const icdOptions = useClinicalModificationOptions(icdSearchQuery);
+  return /*#__PURE__*/_jsxs(_Fragment, {
+    children: [/*#__PURE__*/_jsxs("div", {
+      className: "space-y-6",
+      children: [/*#__PURE__*/_jsx("h5", {
+        className: "text-sm ui-form-field__label m-0",
+        children: "AUTHORIZATION REQUEST"
+      }), /*#__PURE__*/_jsxs("dl", {
+        className: "grid grid-cols-3 gap-x-6 gap-y-2",
+        children: [/*#__PURE__*/_jsx(AuthFormLineItem, {
+          field: "Contracted Program",
+          children: feeScheduleProgram.name
+        }), /*#__PURE__*/_jsx(AuthFormLineItem, {
+          field: "Payment Approach",
+          children: fspUtils.PAYMENT_TYPES[feeScheduleProgram.payment_type] || 'N/A'
+        }), showUnits && /*#__PURE__*/_jsx(AuthFormLineItem, {
+          field: "Unit",
+          children: feeScheduleProgram.unit
+        }), showRate && /*#__PURE__*/_jsxs(AuthFormLineItem, {
+          field: "Rate",
+          children: [/*#__PURE__*/_jsx(DollarAmount, {
+            value: feeScheduleProgram.unit_rate,
+            convertCents: true
+          }), ' per ', feeScheduleProgram.unit]
+        }), /*#__PURE__*/_jsx(AuthFormLineItem, {
+          field: "Program Cap",
+          children: feeScheduleProgram.cap_information ? /*#__PURE__*/_jsx("div", {
+            dangerouslySetInnerHTML: {
+              __html: feeScheduleProgram.cap_information
+            }
+          }) : 'No cap'
+        })]
+      }), /*#__PURE__*/_jsx("hr", {
+        className: "p-0"
+      }), /*#__PURE__*/_jsxs("div", {
+        className: "grid grid-cols-3 gap-x-6 gap-y-3",
+        children: [/*#__PURE__*/_jsx(Field, {
+          name: "paymentAuthForm.amount_requested",
+          children: params => isCostBased ? /*#__PURE__*/_jsx(CurrencyField, _objectSpread({
+            className: "col-span-1 px-0",
+            id: "authorization-request-amount-requested",
+            label: "Amount Requested",
+            required: true
+          }, params)) : /*#__PURE__*/_jsx(InputField, _objectSpread({
+            className: "col-span-1 px-0",
+            id: "authorization-request-amount-requested",
+            label: "Amount Requested",
+            type: "number",
+            required: true
+          }, params))
+        }), /*#__PURE__*/_jsxs("div", {
+          className: "col-span-2 p-0 space-y-2",
+          children: [/*#__PURE__*/_jsx("div", {
+            className: "font-heavy-font text-dark-grey",
+            children: "Unit"
+          }), /*#__PURE__*/_jsx("div", {
+            className: "capitalize",
+            children: isCostBased ? 'Dollars' : pluralize(feeScheduleProgram.unit || '', (formValues === null || formValues === void 0 || (_formValues$amount_re = formValues.amount_requested) === null || _formValues$amount_re === void 0 ? void 0 : _formValues$amount_re.value) || 0)
+          })]
+        }), /*#__PURE__*/_jsx("div", {
+          className: "col-span-1 p-0 m-0",
+          children: /*#__PURE__*/_jsx(Field, {
+            name: "paymentAuthForm.service_start",
+            children: startProps => /*#__PURE__*/_jsx(Field, {
+              name: "paymentAuthForm.service_end",
+              children: endProps => /*#__PURE__*/_jsx(DurationField, {
+                id: "authorization-request-service-dates",
+                label: "Service Delivery Date(s)",
+                startField: startProps,
+                startFieldPath: "startField",
+                endField: endProps,
+                endFieldPath: "endField",
+                required: true,
+                style: {
+                  container: {
+                    width: 'unset'
+                  }
+                }
+              })
+            })
+          })
+        }), feeScheduleProgram.cm_code_required_on_authorization && /*#__PURE__*/_jsx(_Fragment, {
+          children: /*#__PURE__*/_jsx("div", {
+            className: "col-span-1 p-0 m-0 mb-8 row-start-4",
+            "data-testid": "icd10-dropdown",
+            children: /*#__PURE__*/_jsx(Field, {
+              name: "paymentAuthForm.icd10_code",
+              children: params => {
+                const onSelectionChange = newVal => {
+                  params.input.onChange(newVal);
+                  setIcdSearchQuery(newVal.label);
+                };
+                const onInputChange = value => {
+                  setIcdSearchQuery(value);
+                  params.input.onChange('');
+                };
+                return /*#__PURE__*/_jsx(SearchableField, _objectSpread({
+                  className: "",
+                  id: "authorization-request-icd10-code",
+                  label: "ICD-10 Code",
+                  labelClassName: "tracking-normal",
+                  onChange: onSelectionChange,
+                  options: icdOptions,
+                  onInputChange: onInputChange,
+                  placeholder: "Select an ICD-10 code",
+                  clearable: true,
+                  required: true
+                }, params));
+              }
+            })
+          })
+        })]
+      })]
+    }), hasDatesSelected && /*#__PURE__*/_jsxs(_Fragment, {
+      children: [/*#__PURE__*/_jsx("hr", {
+        className: "mb-6"
+      }), /*#__PURE__*/_jsx(CapsInfo, {
+        feeScheduleProgram: feeScheduleProgram,
+        formValues: formValues,
+        isCostBased: isCostBased,
+        setReferralErrors: setReferralErrors
+      })]
+    })]
+  });
 };
 AuthorizationSubform.propTypes = {
   feeScheduleProgram: PropTypes.object.isRequired,

package/dist/pages/builder/AuthorizationSubform.js.map

@@ -1 +1 @@
-{"version":3,"file":"AuthorizationSubform.js","names":["React","useState","PropTypes","Field","pluralize","fspUtils","CapsInfo","DurationField","InputField","SearchableField","CurrencyField","DollarAmount","useClinicalModificationOptions","LineItem","AuthFormLineItem","props","createElement","_extends","fieldClassName","valueClassName","AuthorizationSubform","_ref","_formValues$paymentAu","_formValues$paymentAu2","_formValues$amount_re","feeScheduleProgram","formValues","setReferralErrors","isCostBased","isCostPaymentType","payment_type","showUnits","unit","showRate","unit_rate","hasDatesSelected","paymentAuthForm","service_start","service_end","_useState","undefined","_useState2","_slicedToArray","icdSearchQuery","setIcdSearchQuery","icdOptions","Fragment","className","field","name","PAYMENT_TYPES","value","convertCents","cap_information","dangerouslySetInnerHTML","__html","params","id","label","required","type","amount_requested","startProps","endProps","startField","startFieldPath","endField","endFieldPath","style","container","width","cm_code_required_on_authorization","onSelectionChange","newVal","input","onChange","onInputChange","labelClassName","options","placeholder","clearable","propTypes","object","isRequired","func"],"sources":["../../../src/pages/builder/AuthorizationSubform.js"],"sourcesContent":["import React, { useState } from 'react';\nimport PropTypes from 'prop-types';\nimport { Field } from 'react-final-form';\nimport pluralize from 'pluralize';\nimport fspUtils from '@unite-us/client-utils/dist/utils/feeSchedulePrograms';\nimport CapsInfo from '../../components/service_authorization/CapsInfo';\nimport {\n  DurationField,\n} from '@unite-us/ui';\nimport { InputField } from '@unite-us/app-components';\nimport SearchableField from '../../components/SearchableField';\nimport CurrencyField from '../../common/form/CurrencyField';\nimport DollarAmount from '../../components/DollarAmount';\nimport useClinicalModificationOptions from '../../hooks/useClinicalModificationOptions';\nimport LineItem from './LineItem';\n\nconst AuthFormLineItem = (props) => (\n  <LineItem\n    fieldClassName=\"col-span-1 p-0 text-dark-grey\"\n    valueClassName=\"col-span-2 m-0 p-0 text-dark-blue\"\n    {...props}\n  />\n);\n\nconst AuthorizationSubform = ({ feeScheduleProgram, formValues, setReferralErrors }) => {\n  const isCostBased = fspUtils.isCostPaymentType(feeScheduleProgram.payment_type);\n  const showUnits = !isCostBased && feeScheduleProgram?.unit;\n  const showRate = showUnits && feeScheduleProgram?.unit_rate > 0;\n  const hasDatesSelected = !!(\n    formValues?.paymentAuthForm?.service_start &&\n    formValues?.paymentAuthForm?.service_end\n  );\n  const [icdSearchQuery, setIcdSearchQuery] = useState(undefined);\n  const icdOptions = useClinicalModificationOptions(icdSearchQuery);\n\n  return (\n    <>\n      <div className=\"space-y-6\">\n        <h5 className=\"text-sm ui-form-field__label m-0\">\n          AUTHORIZATION REQUEST\n        </h5>\n        <dl className=\"grid grid-cols-3 gap-x-6 gap-y-2\">\n          <AuthFormLineItem field=\"Contracted Program\">\n            {feeScheduleProgram.name}\n          </AuthFormLineItem>\n          <AuthFormLineItem field=\"Payment Approach\">\n            {fspUtils.PAYMENT_TYPES[feeScheduleProgram.payment_type] || 'N/A'}\n          </AuthFormLineItem>\n          {showUnits && (\n            <AuthFormLineItem field=\"Unit\">\n              {feeScheduleProgram.unit}\n            </AuthFormLineItem>\n          )}\n          {showRate && (\n            <AuthFormLineItem field=\"Rate\">\n              <DollarAmount value={feeScheduleProgram.unit_rate} convertCents />\n              {' per '}\n              {feeScheduleProgram.unit}\n            </AuthFormLineItem>\n          )}\n          <AuthFormLineItem field=\"Program Cap\">\n            {feeScheduleProgram.cap_information ? (\n              <div dangerouslySetInnerHTML={{ __html: feeScheduleProgram.cap_information }} />\n            ) : (\n              'No cap'\n            )}\n          </AuthFormLineItem>\n        </dl>\n        <hr className=\"p-0\" />\n        <div className=\"grid grid-cols-3 gap-x-6 gap-y-3\">\n          <Field\n            name=\"paymentAuthForm.amount_requested\"\n          >\n            {(params) => (isCostBased ? (\n              <CurrencyField\n                className=\"col-span-1 px-0\"\n                id=\"authorization-request-amount-requested\"\n                label=\"Amount Requested\"\n                required\n                {...params}\n              />\n            ) : (\n              <InputField\n                className=\"col-span-1 px-0\"\n                id=\"authorization-request-amount-requested\"\n                label=\"Amount Requested\"\n                type=\"number\"\n                required\n                {...params}\n              />\n            ))}\n          </Field>\n          <div className=\"col-span-2 p-0 space-y-2\">\n            <div className=\"font-heavy-font text-dark-grey\">Unit</div>\n            <div className=\"capitalize\">\n              {isCostBased ? 'Dollars' :\n                pluralize(\n                  feeScheduleProgram.unit || '',\n                  formValues?.amount_requested?.value || 0,\n                )}\n            </div>\n          </div>\n          <div className=\"col-span-1 p-0 m-0\">\n            <Field name=\"paymentAuthForm.service_start\">\n              {(startProps) => (\n                <Field name=\"paymentAuthForm.service_end\">\n                  {(endProps) => (\n                    <DurationField\n                      id=\"authorization-request-service-dates\"\n                      label=\"Service Delivery Date(s)\"\n                      startField={startProps}\n                      startFieldPath=\"startField\"\n                      endField={endProps}\n                      endFieldPath=\"endField\"\n                      required\n                      style={{ container: { width: 'unset' } }}\n                    />\n                  )}\n                </Field>\n              )}\n            </Field>\n          </div>\n          {feeScheduleProgram.cm_code_required_on_authorization && (\n            <>\n              <div className=\"col-span-1 p-0 m-0 mb-8 row-start-4\" data-testid=\"icd10-dropdown\">\n                <Field name=\"paymentAuthForm.icd10_code\">\n                  {(params) => {\n                    const onSelectionChange = (newVal) => {\n                      params.input.onChange(newVal);\n                      setIcdSearchQuery(newVal.label);\n\n                    };\n\n                    const onInputChange = (value) => {\n                      setIcdSearchQuery(value);\n                      params.input.onChange('');\n                    };\n\n                    return (\n                      <SearchableField\n                        className=\"\"\n                        id=\"authorization-request-icd10-code\"\n                        label=\"ICD-10 Code\"\n                        labelClassName=\"tracking-normal\"\n                        onChange={onSelectionChange}\n                        options={icdOptions}\n                        onInputChange={onInputChange}\n                        placeholder=\"Select an ICD-10 code\"\n                        clearable\n                        required\n                        {...params}\n                      />\n                    );\n                  }}\n                </Field>\n              </div>\n            </>\n          )}\n        </div>\n      </div>\n      {\n        hasDatesSelected &&\n        <>\n          <hr className=\"mb-6\"/>\n          <CapsInfo\n            feeScheduleProgram={feeScheduleProgram}\n            formValues={formValues}\n            isCostBased={isCostBased}\n            setReferralErrors={setReferralErrors}\n          />\n        </>\n      }\n    </>\n  );\n};\n\nAuthorizationSubform.propTypes = {\n  feeScheduleProgram: PropTypes.object.isRequired,\n  formValues: PropTypes.object.isRequired,\n  setReferralErrors: PropTypes.func.isRequired,\n};\n\nexport default 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+{"version":3,"file":"AuthorizationSubform.js","names":["React","useState","PropTypes","Field","pluralize","fspUtils","CapsInfo","DurationField","InputField","SearchableField","CurrencyField","DollarAmount","useClinicalModificationOptions","LineItem","jsx","_jsx","jsxs","_jsxs","Fragment","_Fragment","AuthFormLineItem","props","_objectSpread","fieldClassName","valueClassName","AuthorizationSubform","_ref","_formValues$paymentAu","_formValues$paymentAu2","_formValues$amount_re","feeScheduleProgram","formValues","setReferralErrors","isCostBased","isCostPaymentType","payment_type","showUnits","unit","showRate","unit_rate","hasDatesSelected","paymentAuthForm","service_start","service_end","icdSearchQuery","setIcdSearchQuery","undefined","icdOptions","children","className","field","name","PAYMENT_TYPES","value","convertCents","cap_information","dangerouslySetInnerHTML","__html","params","id","label","required","type","amount_requested","startProps","endProps","startField","startFieldPath","endField","endFieldPath","style","container","width","cm_code_required_on_authorization","onSelectionChange","newVal","input","onChange","onInputChange","labelClassName","options","placeholder","clearable","propTypes","object","isRequired","func"],"sources":["../../../src/pages/builder/AuthorizationSubform.js"],"sourcesContent":["import React, { useState } from 'react';\nimport PropTypes from 'prop-types';\nimport { Field } from 'react-final-form';\nimport pluralize from 'pluralize';\nimport fspUtils from '@unite-us/client-utils/dist/utils/feeSchedulePrograms';\nimport CapsInfo from '../../components/service_authorization/CapsInfo';\nimport {\n  DurationField,\n} from '@unite-us/ui';\nimport { InputField } from '@unite-us/app-components';\nimport SearchableField from '../../components/SearchableField';\nimport CurrencyField from '../../common/form/CurrencyField';\nimport DollarAmount from '../../components/DollarAmount';\nimport useClinicalModificationOptions from '../../hooks/useClinicalModificationOptions';\nimport LineItem from './LineItem';\n\nconst AuthFormLineItem = (props) => (\n  <LineItem\n    fieldClassName=\"col-span-1 p-0 text-dark-grey\"\n    valueClassName=\"col-span-2 m-0 p-0 text-dark-blue\"\n    {...props}\n  />\n);\n\nconst AuthorizationSubform = ({ feeScheduleProgram, formValues, setReferralErrors }) => {\n  const isCostBased = fspUtils.isCostPaymentType(feeScheduleProgram.payment_type);\n  const showUnits = !isCostBased && feeScheduleProgram?.unit;\n  const showRate = showUnits && feeScheduleProgram?.unit_rate > 0;\n  const hasDatesSelected = !!(\n    formValues?.paymentAuthForm?.service_start &&\n    formValues?.paymentAuthForm?.service_end\n  );\n  const [icdSearchQuery, setIcdSearchQuery] = useState(undefined);\n  const icdOptions = useClinicalModificationOptions(icdSearchQuery);\n\n  return (\n    <>\n      <div className=\"space-y-6\">\n        <h5 className=\"text-sm ui-form-field__label m-0\">\n          AUTHORIZATION REQUEST\n        </h5>\n        <dl className=\"grid grid-cols-3 gap-x-6 gap-y-2\">\n          <AuthFormLineItem field=\"Contracted Program\">\n            {feeScheduleProgram.name}\n          </AuthFormLineItem>\n          <AuthFormLineItem field=\"Payment Approach\">\n            {fspUtils.PAYMENT_TYPES[feeScheduleProgram.payment_type] || 'N/A'}\n          </AuthFormLineItem>\n          {showUnits && (\n            <AuthFormLineItem field=\"Unit\">\n              {feeScheduleProgram.unit}\n            </AuthFormLineItem>\n          )}\n          {showRate && (\n            <AuthFormLineItem field=\"Rate\">\n              <DollarAmount value={feeScheduleProgram.unit_rate} convertCents />\n              {' per '}\n              {feeScheduleProgram.unit}\n            </AuthFormLineItem>\n          )}\n          <AuthFormLineItem field=\"Program Cap\">\n            {feeScheduleProgram.cap_information ? (\n              <div dangerouslySetInnerHTML={{ __html: feeScheduleProgram.cap_information }} />\n            ) : (\n              'No cap'\n            )}\n          </AuthFormLineItem>\n        </dl>\n        <hr className=\"p-0\" />\n        <div className=\"grid grid-cols-3 gap-x-6 gap-y-3\">\n          <Field\n            name=\"paymentAuthForm.amount_requested\"\n          >\n            {(params) => (isCostBased ? (\n              <CurrencyField\n                className=\"col-span-1 px-0\"\n                id=\"authorization-request-amount-requested\"\n                label=\"Amount Requested\"\n                required\n                {...params}\n              />\n            ) : (\n              <InputField\n                className=\"col-span-1 px-0\"\n                id=\"authorization-request-amount-requested\"\n                label=\"Amount Requested\"\n                type=\"number\"\n                required\n                {...params}\n              />\n            ))}\n          </Field>\n          <div className=\"col-span-2 p-0 space-y-2\">\n            <div className=\"font-heavy-font text-dark-grey\">Unit</div>\n            <div className=\"capitalize\">\n              {isCostBased ? 'Dollars' :\n                pluralize(\n                  feeScheduleProgram.unit || '',\n                  formValues?.amount_requested?.value || 0,\n                )}\n            </div>\n          </div>\n          <div className=\"col-span-1 p-0 m-0\">\n            <Field name=\"paymentAuthForm.service_start\">\n              {(startProps) => (\n                <Field name=\"paymentAuthForm.service_end\">\n                  {(endProps) => (\n                    <DurationField\n                      id=\"authorization-request-service-dates\"\n                      label=\"Service Delivery Date(s)\"\n                      startField={startProps}\n                      startFieldPath=\"startField\"\n                      endField={endProps}\n                      endFieldPath=\"endField\"\n                      required\n                      style={{ container: { width: 'unset' } }}\n                    />\n                  )}\n                </Field>\n              )}\n            </Field>\n          </div>\n          {feeScheduleProgram.cm_code_required_on_authorization && (\n            <>\n              <div className=\"col-span-1 p-0 m-0 mb-8 row-start-4\" data-testid=\"icd10-dropdown\">\n                <Field name=\"paymentAuthForm.icd10_code\">\n                  {(params) => {\n                    const onSelectionChange = (newVal) => {\n                      params.input.onChange(newVal);\n                      setIcdSearchQuery(newVal.label);\n\n                    };\n\n                    const onInputChange = (value) => {\n                      setIcdSearchQuery(value);\n                      params.input.onChange('');\n                    };\n\n                    return (\n                      <SearchableField\n                        className=\"\"\n                        id=\"authorization-request-icd10-code\"\n                        label=\"ICD-10 Code\"\n                        labelClassName=\"tracking-normal\"\n                        onChange={onSelectionChange}\n                        options={icdOptions}\n                        onInputChange={onInputChange}\n                        placeholder=\"Select an ICD-10 code\"\n                        clearable\n                        required\n                        {...params}\n                      />\n                    );\n                  }}\n                </Field>\n              </div>\n            </>\n          )}\n        </div>\n      </div>\n      {\n        hasDatesSelected &&\n        <>\n          <hr className=\"mb-6\"/>\n          <CapsInfo\n            feeScheduleProgram={feeScheduleProgram}\n            formValues={formValues}\n            isCostBased={isCostBased}\n            setReferralErrors={setReferralErrors}\n          />\n        </>\n      }\n    </>\n  );\n};\n\nAuthorizationSubform.propTypes = {\n  feeScheduleProgram: PropTypes.object.isRequired,\n  formValues: PropTypes.object.isRequired,\n  setReferralErrors: 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