import React$1 from 'react';

/**
 * CMS-1500 Form Data Types
 *
 * Maps to the 33 numbered boxes on the standard CMS-1500 (02/12) claim form.
 * All fields are optional to support partial rendering.
 */
/** Insurance type checkboxes (Box 1) */
type InsuranceType = 'medicare' | 'medicaid' | 'tricare' | 'champva' | 'group_health' | 'feca_blk_lung' | 'other';
/** Sex field */
type Sex = 'M' | 'F';
/** Patient relationship to insured (Box 6) */
type PatientRelationship = 'Self' | 'Spouse' | 'Child' | 'Other';
/** Employment/accident status (Boxes 10a-c) */
interface ConditionRelatedTo {
    employment?: boolean;
    autoAccident?: boolean;
    autoAccidentState?: string;
    otherAccident?: boolean;
}
/** Address structure */
interface CMS1500Address {
    line1?: string;
    line2?: string;
    city?: string;
    state?: string;
    zipcode?: string;
}
/** Diagnosis code entry (Box 21, A-L) */
interface DiagnosisCode {
    code: string;
}
/** Procedure code entry for service lines (Box 24) */
interface ProcedureCodeEntry {
    /** CPT/HCPCS code — can be object { key: "code-desc" } or string */
    procedureCode?: Record<string, string> | string;
    /** Modifiers — can be object { key: "mod-desc" } or string[] */
    modifiers?: Record<string, string> | string[];
    /** Diagnosis pointers (A-L letters referencing Box 21) */
    diagnosisFirstPointers?: string;
    diagnosisSecondPointers?: string;
    diagnosisThirdPointers?: string;
    diagnosisFourthPointers?: string;
    /** Charges */
    charges?: number | string;
    /** Units/quantity */
    quantity?: number | string;
    /** EPSDT/Family Plan */
    epsdt?: string;
    /** Type of service */
    typeOfService?: string;
}
/** Insurance details */
interface InsuranceInfo {
    planName?: string;
    policyNumber?: string;
    address?: CMS1500Address;
    phoneNumber?: string;
    dob?: string;
    sex?: Sex;
}
/** Complete CMS-1500 form data */
interface CMS1500Data {
    /** Insurance plan details */
    patientInsurance?: InsuranceInfo;
    /** Box 1: Insurance type */
    insuranceType?: InsuranceType;
    /** Box 1a: Insured's ID number */
    insuranceId?: string;
    /** Box 2: Patient's full name */
    patientName?: string;
    /** Box 3: Patient's DOB (YYYY-MM-DD format) */
    patientDOB?: string;
    /** Box 3: Patient's sex */
    patientSex?: Sex;
    /** Box 5: Patient address */
    patientAddress?: CMS1500Address;
    /** Box 5: Patient phone (e.g. "(555) 123-4567") */
    patientPhone?: string;
    /** Box 4: Insured's name (defaults to patientName if self) */
    insuredName?: string;
    /** Box 6: Patient relationship to insured */
    patientRelationship?: PatientRelationship;
    otherInsuredName?: string;
    otherInsuredPolicy?: string;
    otherInsuredPlanName?: string;
    conditionRelatedTo?: ConditionRelatedTo;
    patientSignature?: string;
    patientSignatureDate?: string;
    insuredSignature?: string;
    /** Box 14: Date of current illness (YYYY-MM-DD) */
    dateOfCurrentIllness?: string;
    /** Box 15: Similar illness date (YYYY-MM-DD) */
    dateOfSimilarIllness?: string;
    /** Box 16: Unable to work — from (YYYY-MM-DD) */
    unableToWorkFrom?: string;
    /** Box 16: Unable to work — to (YYYY-MM-DD) */
    unableToWorkTo?: string;
    /** Box 18: Hospitalization — from (YYYY-MM-DD) */
    hospitalizationFrom?: string;
    /** Box 18: Hospitalization — to (YYYY-MM-DD) */
    hospitalizationTo?: string;
    /** Box 17: Referring provider (can be object or string) */
    referringProvider?: Record<string, string> | string;
    /** Box 17a: Referring provider other ID */
    referringProviderOtherId?: string;
    /** Box 17b: Referring provider NPI */
    referringProviderNPI?: string;
    /** Box 19: Additional claim info */
    additionalClaimInfo?: string;
    /** Box 20: Outside lab charges */
    outsideLab?: boolean;
    outsideLabCharges?: number | string;
    /** NUCC Use field */
    nuccUse?: string;
    /** Box 21: Diagnosis codes (A-L, up to 12) */
    diagnisisCodeData?: DiagnosisCode[];
    resubmissionCode?: string;
    originalRefNumber?: string;
    priorAuthorization?: string;
    /** Date of service for all lines (YYYY-MM-DD) */
    dateOfService?: string;
    /** Place of service code for all lines */
    posCode?: string;
    /** Rendering provider NPI for all lines */
    renderingProviderNPI?: string;
    /** Box 24: Procedure codes/service lines (up to 6) */
    patientProcedureCodes?: ProcedureCodeEntry[];
    /** Box 25: Federal Tax ID */
    federalTaxId?: string;
    /** Box 25: SSN or EIN */
    federalTaxIdType?: 'SSN' | 'EIN';
    /** Box 26: Patient account number */
    patientAccountNumber?: string;
    /** Box 27: Accept assignment */
    acceptAssignment?: boolean;
    /** Box 28: Total charge */
    total?: number;
    /** Box 29: Amount paid */
    amountPaid?: number | string;
    /** Box 31: Physician signature */
    physicianSignature?: string;
    physicianSignatureDate?: string;
    /** Box 32: Service facility */
    serviceLocation?: Record<string, string> | string;
    serviceFacilityName?: string;
    serviceFacilityAddress?: string;
    /** Box 33: Billing provider */
    billingProvider?: Record<string, string> | string;
    billingProviderName?: string;
    billingProviderAddress?: string;
    billingProviderPhone?: string;
    /** Box 33a/b: NPI and group */
    billingProviderNPI?: string;
    billingProviderGroupNPI?: string;
}
/** Props for the CMS1500 PDF viewer component */
interface CMS1500FormProps {
    /** Form data to render */
    data: CMS1500Data;
    /** URL or path to the CMS-1500 PDF template */
    pdfTemplateUrl?: string;
    /** Callback when PDF is generated successfully */
    onPdfReady?: (pdfUrl: string) => void;
    /** Callback on error */
    onError?: (error: Error) => void;
    /** Width of the viewer (default: "100%") */
    width?: string | number;
    /** Height of the viewer (default: "calc(100vh - 120px)") */
    height?: string | number;
    /** Whether to auto-generate PDF on mount (default: true) */
    autoGenerate?: boolean;
    /** Custom CSS class */
    className?: string;
    /** Inline styles */
    style?: React.CSSProperties;
}
/** Options for the PDF generation hook */
interface UseCMS1500Options {
    /** URL or path to the CMS-1500 PDF template */
    pdfTemplateUrl?: string;
    /** Auto-generate on data change (default: false) */
    autoGenerate?: boolean;
}

/**
 * CMS-1500 Form Component
 *
 * Fills a CMS-1500 PDF template with claim data and renders it in an iframe.
 * Uses pdf-lib to write directly into the PDF form fields for pixel-perfect output.
 *
 * HIPAA Note: This component does not store, log, or transmit any data.
 * All PHI is passed via props, rendered client-side, and held only in memory.
 */
declare const CMS1500Form: React$1.FC<CMS1500FormProps>;

interface UseCMS1500Return {
    /** Generated PDF blob URL (null until generated) */
    pdfUrl: string | null;
    /** Whether PDF is currently being generated */
    loading: boolean;
    /** Error from last generation attempt */
    error: Error | null;
    /** Generate/regenerate the PDF */
    generatePdf: (data: CMS1500Data) => Promise<string | null>;
    /** Print the generated PDF */
    handlePrint: () => void;
    /** Download the generated PDF */
    handleDownload: (filename?: string) => void;
    /** Ref for the iframe viewer element */
    iframeRef: React.RefObject<HTMLIFrameElement | null>;
    /** Cleanup blob URL (call on unmount if needed) */
    cleanup: () => void;
}
/**
 * Hook for generating, viewing, printing, and downloading CMS-1500 PDFs.
 *
 * The PDF template is bundled with the package — no file copy or URL needed.
 * If pdfTemplateUrl is provided, it will fetch from that URL instead.
 *
 * No PHI is logged, stored, or transmitted.
 */
declare function useCMS1500(options?: UseCMS1500Options): UseCMS1500Return;

/**
 * Parse a date string (YYYY-MM-DD or ISO) into MM, DD, YY components.
 */
declare function parseDateParts(dateStr?: string): {
    MM: string;
    DD: string;
    YY: string;
};
interface FillCMS1500Options {
    /** Whether to flatten the form after filling (prevents further editing) */
    flatten?: boolean;
}
/**
 * Fill a CMS-1500 PDF template with claim data.
 *
 * @param pdfBytes - The PDF template as ArrayBuffer or Uint8Array
 * @param data - CMS-1500 form data
 * @param options - Optional settings
 * @returns Filled PDF as Uint8Array
 */
declare function fillCMS1500Pdf(pdfBytes: ArrayBuffer | Uint8Array, data: CMS1500Data, options?: FillCMS1500Options): Promise<Uint8Array>;

/**
 * Minimal FHIR R4 types for CMS-1500 mapping.
 *
 * These are intentionally simplified subsets of the full FHIR R4 spec,
 * covering only the fields needed for CMS-1500 form population.
 */
interface FHIRHumanName {
    family?: string;
    given?: string[];
    prefix?: string[];
    suffix?: string[];
}
interface FHIRAddress {
    line?: string[];
    city?: string;
    state?: string;
    postalCode?: string;
    country?: string;
}
interface FHIRContactPoint {
    system?: 'phone' | 'fax' | 'email';
    value?: string;
    use?: 'home' | 'work' | 'mobile';
}
interface FHIRIdentifier {
    system?: string;
    value?: string;
    type?: {
        coding?: Array<{
            system?: string;
            code?: string;
        }>;
    };
}
interface FHIRCoding {
    system?: string;
    code?: string;
    display?: string;
}
interface FHIRCodeableConcept {
    coding?: FHIRCoding[];
    text?: string;
}
interface FHIRReference {
    reference?: string;
    display?: string;
}
interface FHIRPeriod {
    start?: string;
    end?: string;
}
/** Minimal FHIR R4 Patient */
interface FHIRPatient {
    resourceType: 'Patient';
    id?: string;
    identifier?: FHIRIdentifier[];
    name?: FHIRHumanName[];
    birthDate?: string;
    gender?: 'male' | 'female' | 'other' | 'unknown';
    address?: FHIRAddress[];
    telecom?: FHIRContactPoint[];
}
/** Minimal FHIR R4 Practitioner */
interface FHIRPractitioner {
    resourceType: 'Practitioner';
    id?: string;
    identifier?: FHIRIdentifier[];
    name?: FHIRHumanName[];
    address?: FHIRAddress[];
    telecom?: FHIRContactPoint[];
}
/** Minimal FHIR R4 Organization */
interface FHIROrganization {
    resourceType: 'Organization';
    id?: string;
    identifier?: FHIRIdentifier[];
    name?: string;
    address?: FHIRAddress[];
    telecom?: FHIRContactPoint[];
}
/** FHIR Claim diagnosis component */
interface FHIRClaimDiagnosis {
    sequence: number;
    diagnosisCodeableConcept?: FHIRCodeableConcept;
}
/** FHIR Claim item (service line) */
interface FHIRClaimItem {
    sequence: number;
    productOrService: FHIRCodeableConcept;
    modifier?: FHIRCodeableConcept[];
    servicedDate?: string;
    servicedPeriod?: FHIRPeriod;
    locationCodeableConcept?: FHIRCodeableConcept;
    quantity?: {
        value?: number;
    };
    unitPrice?: {
        value?: number;
        currency?: string;
    };
    net?: {
        value?: number;
        currency?: string;
    };
    diagnosisSequence?: number[];
}
/** Minimal FHIR R4 Claim */
interface FHIRClaim {
    resourceType: 'Claim';
    id?: string;
    identifier?: FHIRIdentifier[];
    status?: string;
    type?: FHIRCodeableConcept;
    patient?: FHIRReference;
    provider?: FHIRReference;
    diagnosis?: FHIRClaimDiagnosis[];
    item?: FHIRClaimItem[];
    total?: {
        value?: number;
        currency?: string;
    };
}
/** Bundle for mapping — patient + claim + optional provider/org */
interface FHIRClaimBundle {
    patient: FHIRPatient;
    claim: FHIRClaim;
    provider?: FHIRPractitioner;
    billingOrganization?: FHIROrganization;
    serviceFacility?: FHIROrganization;
    referringProvider?: FHIRPractitioner;
}

/**
 * Maps a FHIR R4 claim bundle to CMS-1500 form data.
 *
 * This is an optional utility — you can also populate CMS1500Data directly.
 * The mapper handles common FHIR patterns but may need customization for
 * specific payer requirements.
 */
declare function mapFHIRToCMS1500(bundle: FHIRClaimBundle): CMS1500Data;

/**
 * Returns the path to the bundled CMS-1500 PDF template relative to node_modules.
 *
 * Usage with common bundlers:
 *
 * **Next.js / CRA / Vite:**
 * Copy the file to your public directory, then use the default (no URL needed).
 *
 * **With copy-webpack-plugin or vite static assets:**
 * ```js
 * import { TEMPLATE_ASSET_PATH } from 'cms1500-react';
 * // TEMPLATE_ASSET_PATH = 'cms1500-react/assets/cms-1500-template.pdf'
 * ```
 */
declare const TEMPLATE_ASSET_PATH = "cms1500-react/assets/cms-1500-template.pdf";
/**
 * Returns the resolved path to the bundled template within node_modules.
 * Useful for build tools to know where to copy from.
 */
declare const TEMPLATE_FILENAME = "cms-1500-template.pdf";

/**
 * Decodes the embedded CMS-1500 PDF template to a Uint8Array.
 * This is the actual PDF template bundled with the package — no fetch or file copy needed.
 */
declare function getEmbeddedTemplate(): Uint8Array;

/** Box 21: Diagnosis codes (A-L → diagnosis1-12) */
declare const DIAGNOSIS_FIELDS: readonly ["diagnosis1", "diagnosis2", "diagnosis3", "diagnosis4", "diagnosis5", "diagnosis6", "diagnosis7", "diagnosis8", "diagnosis9", "diagnosis10", "diagnosis11", "diagnosis12"];
/** Box 23: Prior authorization */
declare const PRIOR_AUTH_FIELD = "prior_auth";
/**
 * Box 24: Service line fields for rows 1-6.
 * Each row has: date from/to (mm/dd/yy), place, EMG, CPT, modifiers (a-c),
 * diagnosis pointer, charges, days, EPSDT, type, rendering NPI.
 */
interface ServiceLineFieldSet {
    svFromMm: string;
    svFromDd: string;
    svFromYy: string;
    svEndMm: string;
    svEndDd: string;
    svEndYy: string;
    place: string;
    emg: string;
    cpt: string;
    mod: string;
    modA: string;
    modB: string;
    modC: string;
    diag: string;
    charge: string;
    days: string;
    epsdt: string;
    type: string;
    localNpi: string;
    localOther: string;
    plan: string;
}
declare const SERVICE_LINE_FIELDS: ServiceLineFieldSet[];
/** Box 31: Physician signature */
declare const PHYSICIAN_FIELDS: {
    readonly signature: "physician_signature";
    readonly date: "physician_date";
};
/** Box 32: Service facility */
declare const FACILITY_FIELDS: {
    readonly name: "fac_name";
    readonly street: "fac_street";
    readonly location: "fac_location";
    readonly npi: "pin1";
    readonly groupNpi: "grp1";
};
/** Box 33: Billing provider */
declare const BILLING_PROVIDER_FIELDS: {
    readonly name: "doc_name";
    readonly street: "doc_street";
    readonly location: "doc_location";
    readonly phoneArea: "doc_phone area";
    readonly phone: "doc_phone";
    readonly npi: "pin";
    readonly groupNpi: "grp";
};

export { BILLING_PROVIDER_FIELDS, type CMS1500Address, type CMS1500Data, CMS1500Form, type CMS1500FormProps, type ConditionRelatedTo, DIAGNOSIS_FIELDS, type DiagnosisCode, FACILITY_FIELDS, type FHIRClaim, type FHIRClaimBundle, type FHIRClaimDiagnosis, type FHIRClaimItem, type FHIROrganization, type FHIRPatient, type FHIRPractitioner, type FillCMS1500Options, type InsuranceInfo, type InsuranceType, PHYSICIAN_FIELDS, PRIOR_AUTH_FIELD, type PatientRelationship, type ProcedureCodeEntry, SERVICE_LINE_FIELDS, type ServiceLineFieldSet, type Sex, TEMPLATE_ASSET_PATH, TEMPLATE_FILENAME, type UseCMS1500Options, type UseCMS1500Return, fillCMS1500Pdf, getEmbeddedTemplate, mapFHIRToCMS1500, parseDateParts, useCMS1500 };