diff --git a/src/main/java/com/ynxbd/common/TestA.java b/src/main/java/com/ynxbd/common/TestA.java
index e18a66c..550e227 100644
--- a/src/main/java/com/ynxbd/common/TestA.java
+++ b/src/main/java/com/ynxbd/common/TestA.java
@@ -4,6 +4,8 @@ import com.alibaba.fastjson.JSONObject;
 import com.ynxbd.common.bean.Patient;
 import com.ynxbd.common.helper.common.JsonHelper;
 import com.ynxbd.common.helper.http.OkHttpHelper;
+import com.ynxbd.common.his.HisConfig;
+import com.ynxbd.common.his.HisEnum;
 import com.ynxbd.common.result.JsonResult;
 import com.ynxbd.common.result.JsonResultEnum;
 import com.ynxbd.wx.config.MessagePushConfig;
diff --git a/src/main/java/com/ynxbd/common/action/InHospAction.java b/src/main/java/com/ynxbd/common/action/InHospAction.java
index 27c121b..02761d9 100644
--- a/src/main/java/com/ynxbd/common/action/InHospAction.java
+++ b/src/main/java/com/ynxbd/common/action/InHospAction.java
@@ -188,14 +188,14 @@ public class InHospAction extends BaseAction {
      * @return 住院记录
      */
     @Action("getOutHospRecords")
-    public Result getOutHospRecords(@AesDecode String patientId, String begDate, String endDate) {
+    public Result getOutHospRecords(@AesDecode String openid, @AesDecode String patientId, String begDate, String endDate) {
         try {
-            log.info("[住院]通过患者ID查询住院记录（出院后） patientId={}, begDate={}, endDate={}", patientId, begDate, endDate);
-            if (patientId == null) {
+            log.info("[住院]通过患者ID查询住院记录（出院后）openid={}, patientId={}, begDate={}, endDate={}", openid, patientId, begDate, endDate);
+            if (openid == null || patientId == null) {
                 return Result.error(ResultEnum.PARAM_IS_DEFECT);
             }
 
-            List<InHospitalList> dataList = new InHospService().queryHisOutPatientRecords(patientId);
+            List<InHospitalList> dataList = new InHospService().queryHisOutPatientRecords(openid, patientId);
             boolean hasDateRange = (!ObjectUtils.isEmpty(begDate) && !ObjectUtils.isEmpty(endDate));
 
             List<InHospitalList> records = new ArrayList<>();
@@ -310,7 +310,7 @@ public class InHospAction extends BaseAction {
             return Result.error(ResultEnum.PAY_TYPE_ERROR);
         }
 
-        JSONObject respMedJson = PayService.getMedAuthUrl(merchantEnum, PEnum.OUT_HOSP,  isHttpsWithProxy());
+        JSONObject respMedJson = PayService.getMedAuthUrl(merchantEnum, PEnum.OUT_HOSP, isHttpsWithProxy());
         if (respMedJson != null) {
             return Result.success(respMedJson);
         }
diff --git a/src/main/java/com/ynxbd/common/action/RecipeAction.java b/src/main/java/com/ynxbd/common/action/RecipeAction.java
index 52d42a4..ae55726 100644
--- a/src/main/java/com/ynxbd/common/action/RecipeAction.java
+++ b/src/main/java/com/ynxbd/common/action/RecipeAction.java
@@ -80,9 +80,9 @@ public class RecipeAction extends BaseAction {
      * 获取未缴费项目
      */
     @Action("getRxUnPayList")
-    public Result getRxUnPayList(@AesDecode String patientId, String personNo, String begDate, String endDate) {
-        log.info("[处方]未缴费项目查询 patientId={}, personNo={}, begDate={}, endDate={}", patientId, personNo, begDate, endDate);
-        if (patientId == null || begDate == null || endDate == null) {
+    public Result getRxUnPayList(@AesDecode String openid, @AesDecode String patientId, String personNo, String begDate, String endDate) {
+        log.info("[处方]未缴费项目查询 openid={}, patientId={}, personNo={}, begDate={}, endDate={}", openid, patientId, personNo, begDate, endDate);
+        if (openid == null || patientId == null || begDate == null || endDate == null) {
             return Result.error(ResultEnum.PARAM_IS_DEFECT);
         }
         if (!ObjectUtils.isEmpty(personNo)) {
@@ -93,7 +93,7 @@ public class RecipeAction extends BaseAction {
         }
 
         int days = DateHelper.intervalDays(begDate, endDate, true);
-        List<HisRecipe> hisRecipes = new HisRecipeDao().getRxUnPay(patientId, personNo, days);
+        List<HisRecipe> hisRecipes = new HisRecipeDao().getRxUnPay(openid, patientId, personNo, days);
 
         List<HisRecipe> resultList = new ArrayList<>();
         for (HisRecipe hisRecipe : hisRecipes) {
@@ -117,7 +117,7 @@ public class RecipeAction extends BaseAction {
             return Result.error(ResultEnum.PARAM_IS_DEFECT);
         }
         int days = DateHelper.intervalDays(begDate, endDate, true);
-        List<HisRecipe> hisRecipes = new HisRecipeDao().getRxUnPay(patientId, personNo, days);
+        List<HisRecipe> hisRecipes = new HisRecipeDao().getRxUnPay(null, patientId, personNo, days);
 
         List<HisRecipe> resultList = new ArrayList<>();
         for (HisRecipe hisRecipe : hisRecipes) {
@@ -144,7 +144,7 @@ public class RecipeAction extends BaseAction {
             return Result.error(ResultEnum.PARAM_IS_DEFECT);
         }
         int days = DateHelper.intervalDays(begDate, endDate, true);
-        List<HisRecipe> hisRecipes = new HisRecipeDao().getRxUnPay(patientId, "", days);
+        List<HisRecipe> hisRecipes = new HisRecipeDao().getRxUnPay(null, patientId, "", days);
         List<HisRecipe> resultList = new ArrayList<>();
         for (HisRecipe hisRecipe : hisRecipes) {
             if (hisRecipe.getDate() != null && DateHelper.inDateRange(begDate, endDate, hisRecipe.getDate(), DateHelper.DateEnum.yyyy_MM_dd)) {
diff --git a/src/main/java/com/ynxbd/common/bean/pay/Order.java b/src/main/java/com/ynxbd/common/bean/pay/Order.java
index 5f62076..ed05cbd 100644
--- a/src/main/java/com/ynxbd/common/bean/pay/Order.java
+++ b/src/main/java/com/ynxbd/common/bean/pay/Order.java
@@ -38,7 +38,7 @@ public class Order implements Serializable {
     private String payDate;
     // 支付时间
     private String payTime;
-    // openid
+    // openid[支付宝16位,微信28位]
     private String openid;
     // 用于支付的openId
     private String payOpenId;
diff --git a/src/main/java/com/ynxbd/common/dao/his/HisInHospDao.java b/src/main/java/com/ynxbd/common/dao/his/HisInHospDao.java
index 57f5468..b660819 100644
--- a/src/main/java/com/ynxbd/common/dao/his/HisInHospDao.java
+++ b/src/main/java/com/ynxbd/common/dao/his/HisInHospDao.java
@@ -85,8 +85,8 @@ public class HisInHospDao {
      * @param patientId 患者id
      * @return 住院记录
      */
-    public JsonResult queryOutPatientRecords(String patientId, String hisYBZF, boolean isDev) {
-        return HisFactory.His(isDev).getJsonResult(HisEnum.Query_OutPatientRecords, params -> {
+    public JsonResult queryOutPatientRecords(String openid, String patientId, String hisYBZF) {
+        return HisFactory.His(HisConfig.hasDevMedOpenId(openid, HisEnum.Query_OutPatientRecords)).getJsonResult(HisEnum.Query_OutPatientRecords, params -> {
             params.put("PatientID", patientId);
             params.put("CallNo", HisConfig.WECHAT_CALL_NO);
             params.put("YDZF", ObjectUtils.isEmpty(hisYBZF) ? "" : hisYBZF); // [住院]医保
diff --git a/src/main/java/com/ynxbd/common/dao/his/HisMedDao.java b/src/main/java/com/ynxbd/common/dao/his/HisMedDao.java
index 7aea250..7b65ce2 100644
--- a/src/main/java/com/ynxbd/common/dao/his/HisMedDao.java
+++ b/src/main/java/com/ynxbd/common/dao/his/HisMedDao.java
@@ -36,7 +36,7 @@ public class HisMedDao {
      * @param recipeJson 处方json
      * @param totalFee   总金额
      */
-    public static JsonResult rxMedUploadDetails(MerchantEnum merchantEnum, String payAuthNo, String cardNo, String openid, String patientId, String treatNum, String recipeJson, BigDecimal totalFee, String ybAttrib, String ybBZCode, String ybBZName) {
+    public static JsonResult rxMedUploadDetails(MerchantEnum merchantEnum, String openid, String payAuthNo, String cardNo, String patientId, String treatNum, String recipeJson, BigDecimal totalFee, String ybAttrib, String ybBZCode, String ybBZName) {
         List<Recipe> recipeList = JsonHelper.parseArray(recipeJson, Recipe.class);
         if (recipeList == null || recipeList.isEmpty()) {
             return HisFactory.His().createErrorResult("处方数量为 0 或 数据转换失败");
@@ -69,16 +69,17 @@ public class HisMedDao {
         if (ObjectUtils.isNotEmpty(ybBZName)) {
             params.put("YBBZName", ybBZName);
         }
-        return HisFactory.HisMed(merchantEnum).getJsonResult(HisEnum.AP_Pay_Invoice, params);
+
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.AP_Pay_Invoice)).getJsonResult(HisEnum.AP_Pay_Invoice, params);
     }
 
 
     /**
      * [医保挂号]分时段挂号
      */
-    public static JsonResult regMedUploadDetails(MerchantEnum merchantEnum, Register reg, String payAuthNo, String cardNo, Boolean isSplitTime) {
+    public static JsonResult regMedUploadDetails(MerchantEnum merchantEnum, String openid, Register reg, String payAuthNo, String cardNo, Boolean isSplitTime) {
         if (isSplitTime) {
-            return HisFactory.HisMed(merchantEnum).getJsonResult(HisEnum.AP_Regist_New, params -> {
+            return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.AP_Regist_New)).getJsonResult(HisEnum.AP_Regist_New, params -> {
                 params.put("PatientID", reg.getPatientId());
                 params.put("PayMoney", reg.getPayMoney());
 
@@ -107,7 +108,7 @@ public class HisMedDao {
             });
         }
         // 非分时段挂号 医保支付
-        return HisFactory.HisMed(merchantEnum).getJsonResult(HisEnum.AP_Regist, params -> {
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.AP_Regist)).getJsonResult(HisEnum.AP_Regist, params -> {
             params.put("PatientID", reg.getPatientId());
             params.put("PayMoney", reg.getPayMoney());
             params.put("DeptCode", reg.getDeptCode());
@@ -138,8 +139,8 @@ public class HisMedDao {
      * [测试需调整]
      * 6201 上传费用明细(住院) + 6202 支付下单
      */
-    public static JsonResult outHospMedUploadDetails(MerchantEnum merchantEnum, String payAuthNo, String cardNo, String treatNum) {
-        return HisFactory.His(true).getJsonResult(HisEnum.YDZF_UploadFeesInfo_ZY, params -> {
+    public static JsonResult outHospMedUploadDetails(MerchantEnum merchantEnum, String openid, String payAuthNo, String cardNo, String treatNum) {
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.YDZF_UploadFeesInfo_ZY)).getJsonResult(HisEnum.YDZF_UploadFeesInfo_ZY, params -> {
             params.put("ZYNum", treatNum);
             params.put("PayAuthNo", payAuthNo);
         });
@@ -155,8 +156,8 @@ public class HisMedDao {
      * @param transNo     HIS交易流水号
      * @param bankTransNo HIS流水号
      */
-    public static JsonResult outHospMedPay(MerchantEnum merchantEnum, String mdUserId, String payDate, String payTime, String transNo, String bankTransNo, BigDecimal cashFee, String openId) {
-        return HisFactory.HisMed(merchantEnum, true).getJsonResult(HisEnum.YDZF_SaveToHIS_ZY, params -> {
+    public static JsonResult outHospMedPay(MerchantEnum merchantEnum, String openid, String mdUserId, String payDate, String payTime, String transNo, String bankTransNo, BigDecimal cashFee) {
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.YDZF_SaveToHIS_ZY)).getJsonResult(HisEnum.YDZF_SaveToHIS_ZY, params -> {
             params.put("PayDeviceID", "mobile");
             params.put("UserID_YBZF", mdUserId);
             params.put("PayMoney", cashFee);
@@ -168,7 +169,7 @@ public class HisMedDao {
 
             params.put("PayWay", "4");
             params.put("Token", "");
-            params.put("OpenId", openId);
+            params.put("OpenId", openid);
         });
     }
 
@@ -183,8 +184,8 @@ public class HisMedDao {
      * @param transNo     HIS交易流水号
      * @param bankTransNo HIS流水号
      */
-    public static JsonResult regMedPay(MerchantEnum merchantEnum, String mdUserId, String payDate, String payTime, String transNo, String bankTransNo, BigDecimal cashFee) {
-        return HisFactory.HisMed(merchantEnum).getJsonResult(HisEnum.Medical_PAY, params -> {
+    public static JsonResult regMedPay(MerchantEnum merchantEnum, String openid, String mdUserId, String payDate, String payTime, String transNo, String bankTransNo, BigDecimal cashFee) {
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.Medical_PAY)).getJsonResult(HisEnum.Medical_PAY, params -> {
             params.put("UserID_YBZF", mdUserId);
             params.put("PayMoney", cashFee);
             params.put("PayDate", payDate);
@@ -202,8 +203,8 @@ public class HisMedDao {
      *
      * @param mdInfo 医保下单对象
      */
-    public static JsonResult placeMedOrder(MerchantEnum merchantEnum, MedicalInfo mdInfo) {
-        return HisFactory.HisMed(merchantEnum).getJsonResult(HisEnum.Medical_PayOrders, params -> {
+    public static JsonResult placeMedOrder(MerchantEnum merchantEnum, String openid, MedicalInfo mdInfo) {
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.Medical_PayOrders)).getJsonResult(HisEnum.Medical_PayOrders, params -> {
             // 授权码
             params.put("PayAuthNo", mdInfo.getPayAuthNo());
             // 授权token
@@ -226,8 +227,8 @@ public class HisMedDao {
      * @param transNo     HIS交易流水号
      * @param bankTransNo HIS流水号
      */
-    public static JsonResult rxMedPay(MerchantEnum merchantEnum, String mdUserId, String payDate, String payTime, String transNo, String bankTransNo, BigDecimal cashFee) {
-        return HisFactory.HisMed(merchantEnum).getJsonResult(HisEnum.Medical_PAY, params -> {
+    public static JsonResult rxMedPay(MerchantEnum merchantEnum, String openid, String mdUserId, String payDate, String payTime, String transNo, String bankTransNo, BigDecimal cashFee) {
+        return HisFactory.HisMed(merchantEnum, HisConfig.hasDevMedOpenId(openid, HisEnum.Medical_PAY)).getJsonResult(HisEnum.Medical_PAY, params -> {
             params.put("UserID_YBZF", mdUserId);
             params.put("PayMoney", cashFee);
             params.put("PayDate", payDate);
diff --git a/src/main/java/com/ynxbd/common/dao/his/HisRecipeDao.java b/src/main/java/com/ynxbd/common/dao/his/HisRecipeDao.java
index a32770f..2ba5072 100644
--- a/src/main/java/com/ynxbd/common/dao/his/HisRecipeDao.java
+++ b/src/main/java/com/ynxbd/common/dao/his/HisRecipeDao.java
@@ -76,10 +76,10 @@ public class HisRecipeDao {
      * @param patientId 患者id
      * @return 待付费项目
      */
-    public List<HisRecipe> getRxUnPay(String patientId, String personNo, int days) {
+    public List<HisRecipe> getRxUnPay(String openid, String patientId, String personNo, int days) {
         List<HisRecipe> resultList = new ArrayList<>();
 
-        JsonResult jsonResult = HisFactory.His().getJsonResult(HisEnum.AP_Query_UnPay_Invoice, params -> {
+        JsonResult jsonResult = HisFactory.His(HisConfig.hasDevMedOpenId(openid, HisEnum.AP_Query_UnPay_Invoice)).getJsonResult(HisEnum.AP_Query_UnPay_Invoice, params -> {
             params.put("PatientID", patientId);
             params.put("PersonNo", personNo);
             params.put("IsLastWeekFlag", days <= 7 ? "1" : "");
@@ -90,9 +90,9 @@ public class HisRecipeDao {
             return resultList;
         }
 
-        List<HisRecipe> hisRecipe = jsonResult.getDataMapList(HisRecipe.class, "Recipe");
-        if (hisRecipe != null) {
-            resultList = hisRecipe;
+        List<HisRecipe> hisRxList = jsonResult.getDataMapList(HisRecipe.class, "Recipe");
+        if (hisRxList != null) {
+            resultList = hisRxList;
         }
         return resultList;
     }
diff --git a/src/main/java/com/ynxbd/common/his/HisConfig.java b/src/main/java/com/ynxbd/common/his/HisConfig.java
index 53578d1..ca2d0f8 100644
--- a/src/main/java/com/ynxbd/common/his/HisConfig.java
+++ b/src/main/java/com/ynxbd/common/his/HisConfig.java
@@ -27,6 +27,8 @@ public class HisConfig {
     protected static final String HIS_WX_MED_URL;
     protected static final String HIS_ALI_MED_URL;
 
+    public static final String DEV_MED_OPENID_S;
+
 
     // 是否强制打印HIS响应的xml
     public static final Boolean IS_LOG_RESP;
@@ -50,6 +52,7 @@ public class HisConfig {
         IS_REQ_CDATA = config.getBoolean("is_req_cdata", false);
         IS_RX_PREPAY = config.getBoolean("is_rx_prepay", false);
 
+
         String url = config.getString("url");
         if (url == null) {
             log.error("WebService配置文件读取失败");
@@ -60,6 +63,8 @@ public class HisConfig {
         // 医保---------------------------------
         HIS_WX_MED_URL = initSoapURL(config.getString("wx_med_url"));
         HIS_ALI_MED_URL = initSoapURL(config.getString("ali_med_url"));
+        // 用于医保测试的openid集-多个用","隔开
+        DEV_MED_OPENID_S = config.getString("dev_med_openid_s", "");
     }
 
     private static String initSoapURL(String ip) {
@@ -71,4 +76,28 @@ public class HisConfig {
         }
         return "http://" + ip + "/WebService_AB.dll/soap/IInterface_AB";
     }
+
+    /**
+     * 是否为医保测试账号
+     *
+     * @param openid  openid
+     * @param hisEnum his接口
+     * @return bool
+     */
+    public static boolean hasDevMedOpenId(String openid, HisEnum hisEnum) {
+        if (ObjectUtils.isEmpty(openid) || ObjectUtils.isEmpty(DEV_MED_OPENID_S)) {
+            return false;
+        }
+        String[] openIds = DEV_MED_OPENID_S.split(",");
+        for (String item : openIds) {
+            if (item.length() < 16) { // openid[支付宝16位,微信28位]
+                continue;
+            }
+            if (item.equalsIgnoreCase(openid)) {
+                log.warn("[医保测试用户][{}]{}", hisEnum == null ? "" : hisEnum.CODE, openid);
+                return true;
+            }
+        }
+        return false;
+    }
 }
diff --git a/src/main/java/com/ynxbd/common/service/InHospService.java b/src/main/java/com/ynxbd/common/service/InHospService.java
index d692f79..640adcc 100644
--- a/src/main/java/com/ynxbd/common/service/InHospService.java
+++ b/src/main/java/com/ynxbd/common/service/InHospService.java
@@ -10,6 +10,7 @@ import com.ynxbd.common.dao.RefundDao;
 import com.ynxbd.common.dao.his.HisInHospDao;
 import com.ynxbd.common.helper.common.DateHelper;
 import com.ynxbd.common.helper.common.JsonHelper;
+import com.ynxbd.common.his.HisConfig;
 import com.ynxbd.common.his.HisFactory;
 import com.ynxbd.common.result.JsonResult;
 import com.ynxbd.common.result.Result;
@@ -177,23 +178,22 @@ public class InHospService {
      *
      * @param patientId 患者id
      */
-    public List<InHospitalList> queryHisOutPatientRecords(String patientId) throws ServiceException {
-        JsonResult resp = new HisInHospDao().queryOutPatientRecords(patientId, null, false); // 非医保
+    public List<InHospitalList> queryHisOutPatientRecords(String openid, String patientId) throws ServiceException {
+        JsonResult resp = new HisInHospDao().queryOutPatientRecords(openid, patientId, null); // 非医保
         if (!resp.success()) {
             throw new ServiceException(resp.getMessage());
         }
         List<InHospitalList> inHospList = resp.getDataMapList(InHospitalList.class, "Items", "Item");
 
         List<InHospitalList> medInHospList = new ArrayList<>();
-        if ("192970".equals(patientId)) {
-            JsonResult medResp = new HisInHospDao().queryOutPatientRecords(patientId, "1", true); // 医保
+        if (ObjectUtils.isEmpty(HisConfig.DEV_MED_OPENID_S) || HisConfig.hasDevMedOpenId(openid, null)) { // 无测试用户 ||是测试用户
+            JsonResult medResp = new HisInHospDao().queryOutPatientRecords(openid, patientId, "1"); // 医保
             if (!medResp.success()) {
                 throw new ServiceException(medResp.getMessage());
             }
             medInHospList = medResp.getDataMapList(InHospitalList.class, "Items", "Item");
         }
 
-
         List<InHospitalList> dataList = new ArrayList<>();
         for (InHospitalList item : medInHospList) {
             item.setYbFlag(1);
diff --git a/src/main/java/com/ynxbd/common/service/MedicalService.java b/src/main/java/com/ynxbd/common/service/MedicalService.java
index a133dfb..2a1523d 100644
--- a/src/main/java/com/ynxbd/common/service/MedicalService.java
+++ b/src/main/java/com/ynxbd/common/service/MedicalService.java
@@ -99,9 +99,9 @@ public class MedicalService {
         reg.setIdCardNo(cardNo);
 
         String payAuthNo = getPayAuthNo(merchantEnum, openid, qrCode, cardNo, realName);
-        log.info("{}[HIS医保上传明细][挂号]patientId={}, cardNo={}, realName={}, reg={}", merchantEnum.NAME, patientId, ParamHelper.hideIdCardNo(cardNo), realName, reg);
-        JsonResult result = HisMedDao.regMedUploadDetails(merchantEnum, reg, payAuthNo, cardNo, isSplitTime);
-        return noticeHiCreateMedOrder(merchantEnum, payAuthNo, result);
+        log.info("{}[HIS医保上传明细][挂号]openid={}, patientId={}, cardNo={}, realName={}, reg={}", merchantEnum.NAME, openid, patientId, ParamHelper.hideIdCardNo(cardNo), realName, reg);
+        JsonResult result = HisMedDao.regMedUploadDetails(merchantEnum, openid, reg, payAuthNo, cardNo, isSplitTime);
+        return noticeHiCreateMedOrder(merchantEnum, openid, payAuthNo, result);
     }
 
 
@@ -133,8 +133,8 @@ public class MedicalService {
 
         // [验收]测试报告内容[2]
         log.info("{}[HIS医保上传明细][处方] req={patientId:\"{}\", treatNum:\"{}\", totalFee:\"{}\", cardNo:\"{}\", recipeJson:\"{}\"}", merchantEnum.NAME, patientId, treatNum, totalFee, cardNo, recipeJson);
-        JsonResult result = HisMedDao.rxMedUploadDetails(merchantEnum, payAuthNo, cardNo, openid, patientId, treatNum, recipeJson, totalFee, ybAttrib, ybBZCode, ybBZName);
-        return noticeHiCreateMedOrder(merchantEnum, payAuthNo, result);
+        JsonResult result = HisMedDao.rxMedUploadDetails(merchantEnum, openid, payAuthNo, cardNo, patientId, treatNum, recipeJson, totalFee, ybAttrib, ybBZCode, ybBZName);
+        return noticeHiCreateMedOrder(merchantEnum, openid, payAuthNo, result);
     }
 
 
@@ -147,8 +147,8 @@ public class MedicalService {
             payAuthNo = userInfo.getPayAuthNo();
         }
 
-        log.info("{}[HIS医保上传明细][住院结算] treatNum={}, patientId={}, cardNo={}, realName={}", merchantEnum.NAME, treatNum, patientId, ParamHelper.hideIdCardNo(cardNo), realName);
-        JsonResult result = HisMedDao.outHospMedUploadDetails(merchantEnum, payAuthNo, cardNo, treatNum);
+        log.info("{}[HIS医保上传明细][住院结算]openid={}, treatNum={}, patientId={}, cardNo={}, realName={}", merchantEnum.NAME, openid, treatNum, patientId, ParamHelper.hideIdCardNo(cardNo), realName);
+        JsonResult result = HisMedDao.outHospMedUploadDetails(merchantEnum, openid, payAuthNo, cardNo, treatNum);
         if (result == null) {
             throw new ServiceException("[医保]返回数据为空");
         }
@@ -217,7 +217,7 @@ public class MedicalService {
      *
      * @param payAuthNo 授权码
      */
-    private MedicalInfo noticeHiCreateMedOrder(MerchantEnum merchantEnum, String payAuthNo, JsonResult result) throws ServiceException {
+    private MedicalInfo noticeHiCreateMedOrder(MerchantEnum merchantEnum, String openid, String payAuthNo, JsonResult result) throws ServiceException {
         if (result == null) {
             throw new ServiceException("[医保]返回数据为空");
         }
@@ -244,7 +244,7 @@ public class MedicalService {
         medicalInfo.setChrgBchno(chrgBchno);
         medicalInfo.setMdUserId(mdUserId);
 
-        JsonResult resp = HisMedDao.placeMedOrder(merchantEnum, medicalInfo);
+        JsonResult resp = HisMedDao.placeMedOrder(merchantEnum, openid, medicalInfo);
         if (!resp.success()) {
             log.info("[上传明细失败] {}", resp.getMessage());
             throw new ServiceException(resp.getMessage());
@@ -613,7 +613,7 @@ public class MedicalService {
             return false;
         }
 
-        JsonResult jsonResult = HisMedDao.regMedPay(merchantEnum, mdUserId, payDate, payTime, tradeNo, bankTransNo, cashFee);
+        JsonResult jsonResult = HisMedDao.regMedPay(merchantEnum, openid, mdUserId, payDate, payTime, tradeNo, bankTransNo, cashFee);
         if (!jsonResult.success()) {
             String respCode = jsonResult.getCode();
             String respMessage = jsonResult.getMessage();
@@ -715,7 +715,7 @@ public class MedicalService {
             return false;
         }
 //
-        JsonResult jsonResult = HisMedDao.outHospMedPay(merchantEnum, mdUserId, payDate, payTime, tradeNo, bankTransNo, cashFee, openid);
+        JsonResult jsonResult = HisMedDao.outHospMedPay(merchantEnum, openid, mdUserId, payDate, payTime, tradeNo, bankTransNo, cashFee);
         if (!jsonResult.success()) {
             String respCode = jsonResult.getCode();
             String respMessage = jsonResult.getMessage();
@@ -837,7 +837,7 @@ public class MedicalService {
             log.info("{} [医保][处方]更新商户信息成功 outTradeNo={}, bankTransNo={}", merchantEnum.NAME, outTradeNo, bankTransNo);
         }
 
-        JsonResult jsonResult = HisMedDao.rxMedPay(merchantEnum, mdUserId, payDate, payTime, tradeNo, bankTransNo, cashFee);
+        JsonResult jsonResult = HisMedDao.rxMedPay(merchantEnum, openid, mdUserId, payDate, payTime, tradeNo, bankTransNo, cashFee);
         if (!jsonResult.success()) {
             String respCode = jsonResult.getCode();
             String respMessage = jsonResult.getMessage();
diff --git a/src/main/resources/webservice.xml b/src/main/resources/webservice.xml
index 4a892f9..aa6ac7b 100644
--- a/src/main/resources/webservice.xml
+++ b/src/main/resources/webservice.xml
@@ -1 +1 @@
-<?xml version="1.0" encoding="UTF-8"?>
<config>
    <his>
        <is_req_cdata name="州傣医使用-[def:false]">false</is_req_cdata>
        <!-- 处方预结算（第2开关）（注意该配置需联系his开发者确认支持才能开启，否则存在风险！） -->
        <is_rx_prepay name="处方预结算[风险][def:false]">false</is_rx_prepay>
        <!-- 开关配置 -->
        <is_ali_mer name="HIS是否开启支付宝分开对账-[def:false]">false</is_ali_mer>
        <is_log_resp name="是否强制打印响应xml数据-[def:false]">false</is_log_resp>
        <is_push_msg name="是否传递openid给His推送消息-[def:false]">false</is_push_msg>
        <!-- 医保 -->
        <wx_med_url name="[微信医保]">127.0.0.1:8888</wx_med_url>
        <ali_med_url name="[支付宝医保]">127.0.0.1:8888</ali_med_url>
        <!-- HIS -->
        <dev_url name="[测试环境]">200.200.200.60:7777</dev_url>
<!--        <url name="[正式环境]">200.200.200.60:7777</url>-->

        <url name="德宏中医">200.200.200.60:7777</url>
    </his>

</config>
\ No newline at end of file
+<?xml version="1.0" encoding="UTF-8"?>
<config>
    <his>
        <is_req_cdata name="州傣医使用-[def:false]">false</is_req_cdata>
        <!-- 处方预结算（第2开关）（注意该配置需联系his开发者确认支持才能开启，否则存在风险！） -->
        <is_rx_prepay name="处方预结算[风险][def:false]">false</is_rx_prepay>
        <!-- 开关配置 -->
        <is_ali_mer name="HIS是否开启支付宝分开对账-[def:false]">false</is_ali_mer>
        <is_log_resp name="是否强制打印响应xml数据-[def:false]">false</is_log_resp>
        <is_push_msg name="是否传递openid给His推送消息-[def:false]">false</is_push_msg>
        <!-- 医保 -->
        <wx_med_url name="[微信医保]">127.0.0.1:8888</wx_med_url>
        <ali_med_url name="[支付宝医保]">127.0.0.1:8888</ali_med_url>

        <dev_med_openid_s name="[医保测试openid多个用英文逗号隔开]">1</dev_med_openid_s>
        <!-- HIS -->
        <dev_url name="[测试环境]">200.200.200.60:7777</dev_url>
        <!-- <url name="[正式环境]">200.200.200.60:7777</url> -->

        <url name="德宏中医">200.200.200.60:7777</url>
    </his>

</config>
\ No newline at end of file