{if $ERROR} {$ERROR} {else}
{foreach name=inums item=num_set from=$provider->get_insurance_numbers()} {foreachelse} {/foreach} {php} if ( $_GET['showform'] == 'true' ) { {/php}
{$provider->get_name_display()}
{xl t='Company Name'} {xl t='Provider Number'} {xl t='Rendering Provider Number'} {xl t='Group Number'}
{$num_set->get_insurance_company_name()}  {$num_set->get_provider_number()}  {$num_set->get_rendering_provider_number()}  {$num_set->get_group_number()} 
{xl t='No entries found, use the form below to add an entry.'}
{xl t='Add New'}

{if $ins->get_id() eq ""}{xl t='Add Provider Number'}{else}{xl t='Update Provider Number'}{/if}
{php} } else { {/php} {php} } {/php}
{xl t='Insurance Company'} {if $ins->get_id() eq ""} {html_options name="insurance_company_id" options=$ic_array values=$ic_array selected=$ins->get_insurance_company_id()} {else} {$ins->get_insurance_company_name()} {/if}
{xl t='Provider Number'}
{xl t='Provider Number'} ({xl t='Type'}) {html_options name="provider_number_type" options=$ic_type_options_array values=$ins->provider_number_type_array selected=$ins->get_provider_number_type()}
{xl t='Rendering Provider Number'}
{xl t='Rendering Provider Number'} ({xl t='Type'}) {html_options name="rendering_provider_number_type" options=$ic_rendering_type_options_array values=$ins->rendering_provider_number_type_array selected=$ins->get_rendering_provider_number_type()}
{xl t='Group Number'}
{if $ins->get_id() eq ""} {xl t='Save'} {else} {xl t='Save'} {/if} {xl t='Cancel'}
{/if} {literal} {/literal}