USE [420923_2013]
GO
/****** Object: StoredProcedure [dbo].[Pro_MzTc_GetCanFee] Script Date: 01/29/2013 11:00:12 ******/
SET ANSI_NULLS ON
GO
SET QUOTED_IDENTIFIER ON
GO
/*重新计算报销项目*/
ALTER proc [dbo].[Pro_MzTc_GetCanFee]
@OrgCode varchar(12), --服务机构
@CoopMedCode varchar(12), --合作医疗证号
@IDNo varchar(10), --个人序号
@DiagNo varchar(10), --就医序号
@AreaCode varchar(12), --行政区划
@FreeFeeOld numeric(8,2), --修改前的报销金额
@MzTcFlag char(1), --门诊统筹方式 1.县;2.乡镇;3.村;4.组
@Type varchar(1), --可报销费用类型 1.登记 2.一审 3.二审
@dFee numeric(8,2) output
as
declare @Bl numeric(6,2),@MaxFee numeric(10,4),@TotalFee numeric(10,4),@FreeFee numeric(10,4),@FreeFee_Ts numeric(10,4),@AfterFreeFee numeric(10,4),@ZlfAfterFreeFee numeric(10,4),@dSumFreeFee numeric(8,2),@dFreeFee numeric(8,2)
declare @Indate varchar(10),@SGrade varchar(1),@CanFreeFee_Ts numeric(8,2),@HospitalCode varchar(12)
select @Bl=0,@MaxFee=0,@TotalFee=0,@FreeFee=0,@FreeFee_Ts=0,@AfterFreeFee=0,@ZlfAfterFreeFee=0,@dSumFreeFee=0,@dFreeFee=0,@dFee=0,@SGrade='0',@CanFreeFee_Ts=0
declare @dYearMaxFee numeric(8,2),@YearFlag char(1),@Digital int,@BlXz numeric(6,2),@BlCun numeric(6,2)
select @dYearMaxFee = 0,@YearFlag='1',@Digital=2,@BlXz=0,@BlCun=0
declare @DayMaxFeeXz numeric(10,4),@DayMaxFeeCun numeric(10,4),@DayFlag char(1),@MzTcMxb char(1),@Count int
select @DayMaxFeeXz=0,@DayMaxFeeCun=0,@DayFlag='1',@MzTcMxb='2',@Count=0
declare @Zlf varchar(20),@ZlfFlag char(1),@ZlfCount int,@ZlfYear char(1),@ZlFreeFee numeric(10,4)
select @Zlf='',@ZlfFlag='',@ZlfCount=0,@ZlfYear='',@ZlFreeFee=0
declare @FeeNo int,@dPrice numeric(10,4),@dLimitPrice numeric(10,4),@dNum numeric(6,2),@FeeType varchar(6)
select @FeeNo=0,@dPrice=0,@dLimitPrice=0,@dNum=0,@FeeType=''
--取当次就诊时间,医疗机构级别
select @Indate=convert(varchar(10),a.Indate,120),@SGrade=b.Grade,@HospitalCode=a.HospitalCode
from o_cbmzbxdj a,p_Ylfwdw b
where a.HospitalCode=b.OrgCode and a.OrgCode=@OrgCode and a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and a.DiagNO=@DiagNO
if (@SGrade <> '1') and (@SGrade <> '4')
begin
set @dFee=0
return
end
--发生慢性病的不能报销
select @MzTcMxb=ParamValue from p_ParamLists where ParamName='MzTcMxb'
if @MzTcMxb='1'
begin
select @Count=isnull(count(coopmedcode),0) from c_MxbCardInfos where coopmedcode=@CoopMedCode and idno=@IDNo
if @Count > 0
begin
set @dFee=-997
return
end
end
--年封顶及类别，小数位数
select @dYearMaxFee=ParamValue from p_ParamLists where ParamName='MzTcYearMaxFee'
select @YearFlag=ParamValue from p_ParamLists where ParamName='MzTcYearFlag'
select @Digital=ParamValue from p_ParamLists where ParamName='MzTcDigital'
--报销比例
select @BlXz=ParamValue from p_ParamLists where ParamName='MzTcBlXz'
select @BlCun=ParamValue from p_ParamLists where ParamName='MzTcBlCun'
--日封顶及类别
select @DayMaxFeeXz=ParamValue from p_ParamLists where ParamName='MzTcDayMaxFeeXz'
select @DayMaxFeeCun=ParamValue from p_ParamLists where ParamName='MzTcDayMaxFeeCun'
select @DayFlag=ParamValue from p_ParamLists where ParamName='MzTcDayFlag'
--一般诊疗费,7元/天,是否单独封顶,是否纳入年封顶
select @Zlf=ltrim(rtrim(ParamValue)) from p_ParamLists where ParamName='MzTcZlf'
select @ZlfYear=ParamValue from p_ParamLists where ParamName='MzTcZlfYear'
select @ZlfFlag=ParamValue from p_ParamLists where ParamName='MzTcZlfFlag'
--乡镇卫生院
if (@SGrade = '1')
begin
set @Bl=@BlXz/100
set @MaxFee =@DayMaxFeeXz
end
--村卫生室
if (@SGrade = '4')
begin
set @Bl=@BlCun/100
set @MaxFee =@DayMaxFeeCun
end
--取当前患者当日已发生的费用
if @DayFlag='1'
begin
select @AfterFreeFee=isnull(sum(c.FreeFee),0)
from (
select isnull(sum(FreeFee),0) as FreeFee --已审核的
from s_cbmzbxdj
where CoopMedCode=@CoopMedCode and IDNo=@IDNo and convert(varchar(10),Indate,120)=@Indate and mzflag='2'
union all
select isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where CoopMedCode=@CoopMedCode and IDNo=@IDNo and convert(varchar(10),Indate,120)=@Indate and mzflag='2'
union all
select -isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo
) c
end
else
begin
select @AfterFreeFee=isnull(sum(c.FreeFee),0)
from (
select isnull(sum(FreeFee),0) as FreeFee --已审核的
from s_cbmzbxdj
where CoopMedCode=@CoopMedCode and convert(varchar(10),Indate,120)=@Indate and mzflag='2'
union all
select isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where CoopMedCode=@CoopMedCode and convert(varchar(10),Indate,120)=@Indate and mzflag='2'
union all
select -isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo) c
end
--取可报销费用
if @Type = '1'
select @TotalFee=isnull(sum(Fee),0),@FreeFee=isnull(sum(CanFreeFee),0) from o_CbMzTcGrDjZb
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode
and IDNo=@IDNo and DiagNo=@DiagNO
else if @Type = '2'
select @TotalFee=isnull(sum(Fee),0),@FreeFee=isnull(sum(CanFreeFee-KnockOffFee1),0) from o_CbMzTcGrDjZb
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode
and IDNo=@IDNo and DiagNo=@DiagNO
else if @Type = '3'
select @TotalFee=isnull(sum(Fee),0),@FreeFee=isnull(sum(CanFreeFee-KnockOffFee),0) from o_CbMzTcGrDjZb
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode
and IDNo=@IDNo and DiagNo=@DiagNO
--特殊项目：一般诊疗费
if ((@SGrade = '1') or (@SGrade = '4')) and (@Zlf<>'')
begin
--判断本次是否有一般诊疗费及金额
select @FeeNo=isnull(FeeNo,0),@FeeType=FeeTypeCode,@dPrice=Price,@dLimitPrice=LimitPrice,@dNum=Num from o_CbMzTcGrDjZb where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo and ItemCode=@Zlf
if @FeeNo > 0
begin
exec Pro_MzTc_GetItem @OrgCode,@CoopMedCode,@IDNo,@DiagNo,@FeeNo,'1',@FeeType,@Zlf,@dPrice,@dLimitPrice,@dNum,@CanFreeFee_Ts output
update o_CbMzTcGrDjZb set CanFreeFee=@CanFreeFee_Ts
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo and FeeNo=@FeeNo
--取可报销费用
if @Type = '1'
select @FreeFee=isnull(sum(CanFreeFee),0) from o_CbMzTcGrDjZb where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNO
else if @Type = '2'
select @FreeFee=isnull(sum(CanFreeFee-KnockOffFee1),0) from o_CbMzTcGrDjZb where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNO
else if @Type = '3'
select @FreeFee=isnull(sum(CanFreeFee-KnockOffFee),0) from o_CbMzTcGrDjZb where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNO
end
--判断是否超过每日次封顶线,，本次录入一般诊疗且报销(当天未发生过一般诊疗费，@ZlfAfterFreeFee＝0)
if (@FeeNo>0) and (@CanFreeFee_Ts<>0)
begin
--单独日封顶
if (@ZlfFlag ='1')
begin
if @MaxFee > 0
begin
if @AfterFreeFee >= @MaxFee
set @dFee=0
else
begin
if (@FreeFee-@CanFreeFee_Ts)*@Bl + @AfterFreeFee > @MaxFee
set @dFee = @MaxFee - @AfterFreeFee
else
set @dFee = (@FreeFee-@CanFreeFee_Ts)*@Bl
end
end
else
set @dFee = (@FreeFee-@CanFreeFee_Ts)*@Bl
set @dFee=@dFee + @CanFreeFee_Ts
end
else
begin
--纳入日封顶
if @MaxFee > 0
begin
if @AfterFreeFee >= @MaxFee
begin
set @dFee=-998
if @CanFreeFee_Ts > 0
begin
set @CanFreeFee_Ts = 0
update o_cbmztcgrdjzb set CanFreeFee=@CanFreeFee_Ts where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo and ItemCode=@Zlf and CanFreeFee<>0
end
end
else
begin
if (@FreeFee-@CanFreeFee_Ts)*@Bl + @CanFreeFee_Ts + @AfterFreeFee > @MaxFee
begin
set @dFee = @MaxFee - @AfterFreeFee
if @dFee < @CanFreeFee_Ts
begin
set @CanFreeFee_Ts = @dFee
update o_cbmztcgrdjzb set CanFreeFee=@CanFreeFee_Ts where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo and ItemCode=@Zlf and CanFreeFee<>0
end
end
else
set @dFee = (@FreeFee-@CanFreeFee_Ts)*@Bl + @CanFreeFee_Ts
end
end
else
set @dFee = (@FreeFee-@CanFreeFee_Ts)*@Bl + @CanFreeFee_Ts
end
end
else
begin
--单独日封顶
if (@ZlfFlag ='1')
begin
--当天已发生的一般诊疗费
select @ZlfAfterFreeFee=isnull(sum(aa.ZlfFee),0) from
(select isnull(a.ZlfFee,0) as ZlfFee
from s_cbmzbxdj a
where a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and convert(varchar(10),a.Indate,120)=@Indate and a.mzflag='2'
union all
select isnull(a.ZlfFee,0) as ZlfFee
from o_cbmzbxdj a
where a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and convert(varchar(10),a.Indate,120)=@Indate and a.mzflag='2'
union all
select -isnull(a.ZlfFee,0) as ZlfFee
from o_cbmzbxdj a
where a.OrgCode=@OrgCode and a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and a.DiagNo=@DiagNo) aa
if @MaxFee > 0
begin
if (@AfterFreeFee-@ZlfAfterFreeFee)>= @MaxFee
set @dFee=-998
else
begin
if @FreeFee*@Bl + (@AfterFreeFee-@ZlfAfterFreeFee) > @MaxFee
set @dFee = @MaxFee - (@AfterFreeFee-@ZlfAfterFreeFee)
else
set @dFee = @FreeFee*@Bl
end
end
else
set @dFee = @FreeFee*@Bl
end
else
begin
--纳入日封顶
if @MaxFee > 0
begin
if @AfterFreeFee >= @MaxFee
set @dFee=-998
else
begin
if @FreeFee*@Bl + @AfterFreeFee > @MaxFee
set @dFee = @MaxFee - @AfterFreeFee
else
set @dFee = @FreeFee*@Bl
end
end
else
set @dFee = @FreeFee*@Bl
end
end
end
else
begin
--判断是否超过每日次封顶线
if @MaxFee > 0
begin
if @AfterFreeFee >= @MaxFee
set @dFee=-998
else
begin
if @FreeFee*@Bl + @AfterFreeFee > @MaxFee
set @dFee = @MaxFee - @AfterFreeFee
else
set @dFee = @FreeFee*@Bl
end
end
else
set @dFee = @FreeFee*@Bl
end
set @dFee=round(@dFee,@Digital)
if (@dFee>0) and (@dYearMaxFee>0)
begin
--取当前患者全年已发生的费用
if @YearFlag='1'
select @dSumFreeFee=isnull(sum(c.FreeFee),0)
from (
select isnull(sum(FreeFee),0) as FreeFee --已审核的
from s_cbmzbxdj
where CoopMedCode=@CoopMedCode and IDNo=@IDNo and mzflag='2'
union all
select isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where CoopMedCode=@CoopMedCode and IDNo=@IDNo and mzflag='2'
union all
select -isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo) c
else
select @dSumFreeFee=isnull(sum(c.FreeFee),0)
from (
select isnull(sum(FreeFee),0) as FreeFee --已审核的
from s_cbmzbxdj
where CoopMedCode=@CoopMedCode and mzflag='2'
union all
select isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where CoopMedCode=@CoopMedCode and mzflag='2'
union all
select -isnull(sum(FreeFee),0) as FreeFee
from o_cbmzbxdj
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo) c
--一般诊疗不纳入年封顶
if (@Zlf<>'') and (@ZlfYear ='2')
begin
if @YearFlag='1'
select @ZlFreeFee=isnull(sum(aa.ZlfFee),0) from
(select isnull(a.ZlfFee,0) as ZlfFee
from s_cbmzbxdj a
where a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and a.mzflag='2'
union all
select isnull(a.ZlfFee,0) as ZlfFee
from o_cbmzbxdj a
where a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and a.mzflag='2'
union all
select -isnull(a.ZlfFee,0) as ZlfFee
from o_cbmzbxdj a
where a.OrgCode=@OrgCode and a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and a.DiagNo=@DiagNo) aa
else
select @ZlFreeFee=isnull(sum(aa.ZlfFee),0) from
(select isnull(a.ZlfFee,0) as ZlfFee
from s_cbmzbxdj a
where a.CoopMedCode=@CoopMedCode and a.mzflag='2'
union all
select isnull(a.ZlfFee,0) as ZlfFee
from o_cbmzbxdj a
where a.CoopMedCode=@CoopMedCode and a.mzflag='2'
union all
select -isnull(a.ZlfFee,0) as ZlfFee
from o_cbmzbxdj a
where a.OrgCode=@OrgCode and a.CoopMedCode=@CoopMedCode and a.IDNo=@IDNo and a.DiagNo=@DiagNo) aa
set @dSumFreeFee=@dSumFreeFee-@ZlFreeFee
--判断普通金额是否超过年封顶
if (@dSumFreeFee>=@dYearMaxFee)
set @dFee=@CanFreeFee_Ts
else
begin
if (@dFee-@CanFreeFee_Ts)+@dSumFreeFee>@dYearMaxFee set @dFee=@dYearMaxFee-@dSumFreeFee+@CanFreeFee_Ts
end
end
else
begin
--一般诊疗纳入年封顶
if (@dSumFreeFee>=@dYearMaxFee)
begin
set @dFee=-999
if @CanFreeFee_Ts > 0
begin
set @CanFreeFee_Ts=0
update o_cbmztcgrdjzb set CanFreeFee=@CanFreeFee_Ts where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo and ItemCode=@Zlf and CanFreeFee<>0
end
end
else
begin
if @dFee+@dSumFreeFee>@dYearMaxFee
begin
set @dFee=@dYearMaxFee-@dSumFreeFee
if @dFee < @CanFreeFee_Ts
begin
set @CanFreeFee_Ts = @dFee
update o_cbmztcgrdjzb set CanFreeFee=@CanFreeFee_Ts where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo and ItemCode=@Zlf and CanFreeFee<>0
end
end
end
end
end
set @dFreeFee=@dFee
if @dFreeFee<0 set @dFreeFee=0
--更新o_CbMzBxDj
if @Type = '1'
update o_CbMzBxDj set TotalFee=@TotalFee,CanFreeFee=@FreeFee,FreeFee=@dFreeFee,ZlfFee=@CanFreeFee_Ts
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo
else if @Type = '2'
update o_CbMzBxDj set CheckOneFee=@dFreeFee
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo
else if @Type = '3'
update o_CbMzBxDj set CheckFee=@dFreeFee
where OrgCode=@OrgCode and CoopMedCode=@CoopMedCode and IDNo=@IDNo and DiagNo=@DiagNo