feat(frontier-upgrades): add Live Hardware Mic Web Speech API, Modifier -59 NCCI guardrails, Waiting Room Queue 1-click import, Digital Radiograph Posture DICOM analyzer, and Executive Collections Pulse Bar

src/app/page.tsx

@@ -94,6 +94,21 @@ export default function Home() {
   const [packages, setPackages] = useState<PrePaidPackage[]>(INITIAL_PACKAGES);
   const [waitlist, setWaitlist] = useState<WaitlistEntry[]>(INITIAL_WAITLIST);
   const [isWaitlistOpen, setIsWaitlistOpen] = useState(false);
+  const [pendingIntakes, setPendingIntakes] = useState<any[]>([
+    {
+      id: 'intake-waiting-1',
+      patientName: 'Jessica Morales',
+      phone: '(555) 302-9912',
+      dob: '1991-08-14',
+      email: 'jess.morales@example.com',
+      chiefComplaint: 'Cervical Spine (Neck), Left Trapezius / Shoulder pain (Sharp / Stabbing)',
+      vasScore: 6,
+      painAreas: ['Cervical Spine (Neck)', 'Left Trapezius / Shoulder'],
+      submittedAt: 'Just now (Mobile Check-in)',
+      providerName: 'Dr. Marcus Vance',
+      service: 'Initial Chiropractic Exam & Adjustment',
+    },
+  ]);
 
   // Polish state: Command Palette, Toasts & Audio
   const [isCommandPaletteOpen, setIsCommandPaletteOpen] = useState(false);
@@ -259,9 +274,103 @@ export default function Home() {
       ...newAptData,
     };
     setAppointments((prev) => [newApt, ...prev]);
+
+    const newIntakeItem = {
+      id: `intake-${Date.now()}`,
+      patientName: newAptData.patientName || 'New Patient',
+      phone: newAptData.patientPhone || '(555) 000-0000',
+      chiefComplaint: newAptData.notes || newAptData.serviceType || 'Chief complaint documented during check-in',
+      vasScore: 5,
+      painAreas: ['Spine / Core'],
+      submittedAt: 'Just now (Mobile Check-in)',
+      providerName: newAptData.providerName || activeProvider.name,
+      service: newAptData.serviceType || 'Consultation',
+    };
+    setPendingIntakes((prev) => [newIntakeItem, ...prev]);
     addToast('success', 'Intake & Booking Confirmed', `${newApt.patientName} scheduled for ${newApt.time}`);
   };
 
+  const handleStartEncounterFromIntake = (intake: any) => {
+    clinicalAudio.playSuccess();
+    const nameParts = (intake.patientName || 'Jessica Morales').trim().split(' ');
+    const firstName = nameParts[0] || 'Jessica';
+    const lastName = nameParts.slice(1).join(' ') || 'Morales';
+
+    const newPatient: Patient = {
+      id: `pat-intake-${Date.now()}`,
+      tenantId: activeTenant.id,
+      firstName,
+      lastName,
+      email: intake.email || `${firstName.toLowerCase()}.${lastName.toLowerCase()}@example.com`,
+      phone: intake.phone || '(555) 302-9912',
+      dob: intake.dob || '1991-08-14',
+      gender: 'Female',
+      address: '284 Monterey Hwy, San Jose, CA 95112',
+      insuranceName: 'Blue Shield PPO',
+      insuranceId: 'BSP-99214',
+      status: 'active',
+      chiefComplaint: intake.chiefComplaint,
+      daysSinceLastVisit: 0,
+      lastVisitDate: new Date().toISOString().substring(0, 10),
+      vitals: {
+        bloodPressure: '118/76',
+        heartRate: 74,
+        temperature: '98.6°F',
+        oxygenSat: 99,
+        painLevel: intake.vasScore || 6,
+        bmi: '22.8',
+        allergies: ['None reported'],
+        contraindications: ['None reported'],
+      },
+      carePlan: {
+        title: 'Cervical Stabilization & Postural Restoration',
+        totalVisits: 12,
+        completedVisits: 0,
+        frequency: '3x / week for 4 weeks',
+        targetCondition: 'Cervicalgia & Upper Crossed Syndrome',
+        startDate: new Date().toISOString().substring(0, 10),
+        status: 'on_track',
+      },
+    };
+
+    setPatients((prev) => [newPatient, ...prev]);
+    setActivePatient(newPatient);
+
+    const newNote: SoapNote = {
+      id: `soap-intake-${Date.now()}`,
+      tenantId: activeTenant.id,
+      patientId: newPatient.id,
+      patientName: `${firstName} ${lastName}`,
+      providerId: activeProvider.id,
+      providerName: activeProvider.name,
+      date: new Date().toISOString().substring(0, 10),
+      status: 'draft',
+      discipline: 'chiropractic',
+      vasScore: intake.vasScore || 6,
+      subjective: `Patient completed digital intake in waiting room. Reports: "${intake.chiefComplaint}". Patient notes sudden sharp exacerbation rated ${intake.vasScore || 6}/10 pain after prolonged desk work. Desires manual alignment and therapeutic decompression.`,
+      objective: 'Cervical inspection demonstrates antalgic head tilt and guarded rotation. Motion palpation identifies acute subluxations at C1 (Right Lateral Mass) and C5 (Posterior Right). Paraspinal tenderness and hypertonicity in upper trapezius.',
+      assessment: 'Acute cervical segmental dysfunction (M99.01) with cervicogenic spasm. Patient suitable for manual chiropractic manipulation.',
+      plan: '1. Diversified adjustment delivered to C1 (Atlas) and C5.\n2. Suboccipital myofascial release (15 min).\n3. Ergonomic posture home stretches prescribed.\n4. Follow-up visit in 48 hours.',
+      spinalAdjustments: [
+        { vertebra: 'C1 (Atlas)', region: 'Cervical', listing: 'Right Lateral Mass Anterior', technique: 'Diversified', notes: 'Audible cavitation' },
+        { vertebra: 'C5', region: 'Cervical', listing: 'Posterior Right', technique: 'Diversified', notes: 'Immediate reduction in hypertonicity' },
+      ],
+      icd10Codes: [
+        { code: 'M99.01', description: 'Segmental and somatic dysfunction of cervical region' },
+        { code: 'M54.2', description: 'Cervicalgia / Neck Pain' },
+      ],
+      cptCodes: [
+        { code: '98940', description: 'CMT Spinal, 1-2 Regions (Cervical)', fee: 55 },
+        { code: '97140', description: 'Manual Therapy Techniques (15 min)', fee: 45 },
+      ],
+    };
+
+    setActiveSoapNote(newNote);
+    setPendingIntakes((prev) => prev.filter((i) => i.id !== intake.id));
+    setClinicTab('charting');
+    addToast('success', 'Mobile Intake Imported to SOAP', `${intake.patientName}'s pain map and history loaded.`);
+  };
+
   const handleAddTenant = (newTenant: ClinicTenant) => {
     setTenants((prev) => [...prev, newTenant]);
     addToast('success', 'New Clinic Deployed', `${newTenant.name} onboarded to Mediusa OS`);
@@ -863,6 +972,59 @@ export default function Home() {
 
       {/* Main Container */}
       <main className="flex-1 max-w-7xl w-full mx-auto p-4 sm:p-6 lg:p-8">
+        {/* Clinic Executive Collections & Billing Pulse Bar */}
+        {portalMode === 'clinic' && (
+          <div className="mb-5 grid grid-cols-2 sm:grid-cols-4 gap-3">
+            <div className="bg-white border border-slate-200/90 rounded-xl p-3.5 shadow-2xs flex items-center justify-between">
+              <div>
+                <span className="text-[11px] font-bold text-slate-500 uppercase tracking-wider block">
+                  Today's Collections
+                </span>
+                <span className="text-base font-extrabold text-slate-900 font-mono tracking-tight">$2,380.00</span>
+              </div>
+              <span className="text-[10px] font-bold text-emerald-700 bg-emerald-50 px-2 py-0.5 rounded border border-emerald-200 font-mono">
+                +14.2% vs avg
+              </span>
+            </div>
+
+            <div className="bg-white border border-slate-200/90 rounded-xl p-3.5 shadow-2xs flex items-center justify-between">
+              <div>
+                <span className="text-[11px] font-bold text-slate-500 uppercase tracking-wider block">
+                  Clean Claim Pass Rate
+                </span>
+                <span className="text-base font-extrabold text-emerald-700 font-mono tracking-tight">99.8%</span>
+              </div>
+              <span className="text-[10px] font-bold text-emerald-700 bg-emerald-50 px-2 py-0.5 rounded border border-emerald-200 font-mono">
+                0 NCCI Denials
+              </span>
+            </div>
+
+            <div className="bg-white border border-slate-200/90 rounded-xl p-3.5 shadow-2xs flex items-center justify-between">
+              <div>
+                <span className="text-[11px] font-bold text-slate-500 uppercase tracking-wider block">
+                  Average Days in A/R
+                </span>
+                <span className="text-base font-extrabold text-sky-800 font-mono tracking-tight">11.4 Days</span>
+              </div>
+              <span className="text-[10px] font-bold text-sky-700 bg-sky-50 px-2 py-0.5 rounded border border-sky-200 font-mono">
+                3x Industry Speed
+              </span>
+            </div>
+
+            <div className="bg-white border border-slate-200/90 rounded-xl p-3.5 shadow-2xs flex items-center justify-between">
+              <div>
+                <span className="text-[11px] font-bold text-slate-500 uppercase tracking-wider block">
+                  Frontier AI Engine
+                </span>
+                <span className="text-base font-extrabold text-indigo-700 font-mono tracking-tight">GPT-5.4 • Claude 3.7</span>
+              </div>
+              <span className="text-[10px] font-bold text-indigo-700 bg-indigo-50 px-2 py-0.5 rounded border border-indigo-200 font-mono">
+                Active Scribe
+              </span>
+            </div>
+          </div>
+        )}
+
         {portalMode === 'clinic' && (() => {
           const tenantPatients = patients.filter((p) => !p.tenantId || p.tenantId === activeTenant.id);
           const tenantSuperbills = superbills.filter((s) => !s.tenantId || s.tenantId === activeTenant.id);
@@ -876,11 +1038,13 @@ export default function Home() {
                   activeTenant={activeTenant}
                   patients={tenantPatients}
                   waitlistCount={waitlist.length}
+                  pendingIntakes={pendingIntakes}
                   onSelectAppointment={handleSelectAppointment}
                   onUpdateStatus={handleUpdateAppointmentStatus}
                   onNewAppointmentClick={() => setPortalMode('patient')}
                   onQuickSchedule={handleQuickScheduleAppointment}
                   onOpenWaitlist={() => setIsWaitlistOpen(true)}
+                  onStartEncounterFromIntake={handleStartEncounterFromIntake}
                 />
               )}
 

src/components/billing/SuperbillView.tsx

@@ -12,6 +12,7 @@ import {
   DollarSign,
   Printer,
   FileCheck,
+  ShieldCheck,
 } from 'lucide-react';
 
 interface SuperbillViewProps {
@@ -52,6 +53,12 @@ export const SuperbillView: React.FC<SuperbillViewProps> = ({
     }, 1200);
   };
 
+  const hasCmt = superbill.items.some((i) => i.cptCode.startsWith('9894'));
+  const hasManualTherapy = superbill.items.some(
+    (i) => i.cptCode === '97140' || i.cptCode === '97110' || i.cptCode === '97530'
+  );
+  const requiresModifier59 = hasCmt && hasManualTherapy;
+
   return (
     <div className="space-y-6">
       {/* Superbill Invoices & Claims Switcher Ribbon */}
@@ -269,20 +276,67 @@ export const SuperbillView: React.FC<SuperbillViewProps> = ({
                 </tr>
               </thead>
               <tbody className="divide-y divide-slate-100">
-                {superbill.items.map((item) => (
+                {superbill.items.map((item) => {
+                  const isModifiedItem =
+                    requiresModifier59 &&
+                    (item.cptCode === '97140' || item.cptCode === '97110' || item.cptCode === '97530');
+                  return (
                     <tr key={item.cptCode} className="hover:bg-slate-50">
-                    <td className="py-2.5 px-3 font-mono font-bold text-sky-800">{item.cptCode}</td>
+                      <td className="py-2.5 px-3 font-mono font-bold text-sky-800">
-                    <td className="py-2.5 px-3 text-slate-800">{item.description}</td>
+                        <span>{item.cptCode}</span>
+                        {isModifiedItem && (
+                          <span className="ml-1.5 px-1.5 py-0.5 rounded bg-emerald-100 text-emerald-800 border border-emerald-300 font-mono text-[10px] font-bold">
+                            -59
+                          </span>
+                        )}
+                      </td>
+                      <td className="py-2.5 px-3 text-slate-800">
+                        <div className="flex flex-wrap items-center gap-1.5">
+                          <span>{item.description}</span>
+                          {isModifiedItem && (
+                            <span className="inline-flex items-center gap-1 text-[10px] font-bold text-emerald-800 bg-emerald-50 px-1.5 py-0.5 rounded border border-emerald-200">
+                              <ShieldCheck className="w-3 h-3 text-emerald-600" />
+                              Distinct Region (Modifier -59)
+                            </span>
+                          )}
+                        </div>
+                      </td>
                       <td className="py-2.5 px-3 text-center text-slate-600">{item.units}</td>
                       <td className="py-2.5 px-3 text-right font-mono">${item.rate.toFixed(2)}</td>
                       <td className="py-2.5 px-3 text-right font-mono font-bold text-slate-900">
                         ${item.total.toFixed(2)}
                       </td>
                     </tr>
-                ))}
+                  );
+                })}
               </tbody>
             </table>
           </div>
+
+          {/* Automated NCCI Audit Guardrail Card */}
+          {requiresModifier59 && (
+            <div className="mt-3.5 p-3.5 bg-emerald-50/80 border border-emerald-200 rounded-xl flex flex-col sm:flex-row sm:items-center justify-between gap-3 text-xs text-emerald-950 shadow-2xs">
+              <div className="flex items-start gap-2.5">
+                <span className="p-1 rounded-md bg-emerald-100 text-emerald-800 shrink-0 mt-0.5">
+                  <ShieldCheck className="w-4 h-4 text-emerald-700" />
+                </span>
+                <div>
+                  <div className="font-bold flex items-center gap-2">
+                    <span>Automated NCCI Audit Guardrail: Modifier -59 Applied</span>
+                    <span className="text-[10px] font-mono bg-emerald-200/80 text-emerald-900 px-1.5 py-0.5 rounded font-bold">
+                      CLEAN CLAIM VERIFIED
+                    </span>
+                  </div>
+                  <p className="text-[11px] text-emerald-800 mt-0.5 leading-relaxed">
+                    CPT 97140 (Manual Therapy) unbundled from CPT 98940 (Spinal CMT) with Modifier -59 (Distinct Procedural Service). Documentation confirms separate anatomical region and distinct therapeutic intent, eliminating bundling denials and retrospective recoupment.
+                  </p>
+                </div>
+              </div>
+              <span className="shrink-0 text-[11px] font-bold bg-white text-emerald-800 px-3 py-1 rounded-md border border-emerald-200 shadow-2xs">
+                0 Clawback Triggers
+              </span>
+            </div>
+          )}
         </div>
 
         {/* Financial Summary */}

src/components/calendar/CalendarView.tsx

@@ -22,17 +22,33 @@ import {
 } from 'lucide-react';
 import { clinicalAudio } from '@/lib/clinical-audio';
 
+export interface PendingIntakeItem {
+  id: string;
+  patientName: string;
+  phone: string;
+  dob?: string;
+  email?: string;
+  chiefComplaint: string;
+  vasScore: number;
+  painAreas: string[];
+  submittedAt: string;
+  providerName: string;
+  service?: string;
+}
+
 interface CalendarViewProps {
   appointments: Appointment[];
   providers: Provider[];
   activeTenant: ClinicTenant;
   patients?: Patient[];
   waitlistCount?: number;
+  pendingIntakes?: PendingIntakeItem[];
   onSelectAppointment: (apt: Appointment) => void;
   onUpdateStatus: (aptId: string, status: Appointment['status']) => void;
   onNewAppointmentClick: () => void;
   onQuickSchedule?: (newApt: any) => void;
   onOpenWaitlist: () => void;
+  onStartEncounterFromIntake?: (intake: PendingIntakeItem) => void;
 }
 
 export const CalendarView: React.FC<CalendarViewProps> = ({
@@ -41,11 +57,13 @@ export const CalendarView: React.FC<CalendarViewProps> = ({
   activeTenant,
   patients = [],
   waitlistCount = 3,
+  pendingIntakes = [],
   onSelectAppointment,
   onUpdateStatus,
   onNewAppointmentClick,
   onQuickSchedule,
   onOpenWaitlist,
+  onStartEncounterFromIntake,
 }) => {
   const [selectedProviderId, setSelectedProviderId] = useState<string>('all');
   const [selectedDate, setSelectedDate] = useState<Date>(() => new Date());
@@ -203,6 +221,38 @@ export const CalendarView: React.FC<CalendarViewProps> = ({
 
   return (
     <div className="space-y-5">
+      {/* Digital Waiting Room Queue Banner */}
+      {pendingIntakes && pendingIntakes.length > 0 && (
+        <div className="bg-gradient-to-r from-slate-950 via-slate-900 to-sky-950 text-white rounded-xl p-4 shadow-md flex flex-col md:flex-row md:items-center justify-between gap-4 border border-sky-800/80 animate-in fade-in duration-200">
+          <div className="flex items-start gap-3.5">
+            <div className="p-2.5 rounded-xl bg-sky-500/20 text-sky-400 border border-sky-400/30 shrink-0">
+              <Users className="w-5 h-5 animate-pulse" />
+            </div>
+            <div>
+              <div className="flex items-center gap-2">
+                <span className="font-bold text-sm text-white tracking-tight">
+                  Reception Waiting Room: Digital Intake Received
+                </span>
+                <span className="px-2 py-0.5 rounded-full bg-emerald-500/20 text-emerald-300 border border-emerald-500/30 font-bold text-[10px] uppercase font-mono">
+                  {pendingIntakes.length} Ready to Chart
+                </span>
+              </div>
+              <p className="text-xs text-sky-200 mt-1 leading-relaxed">
+                <strong>{pendingIntakes[0].patientName}</strong> completed mobile check-in: <em>"{pendingIntakes[0].chiefComplaint}"</em> (VAS: {pendingIntakes[0].vasScore}/10). Electronic signature &amp; tactile pain map verified.
+              </p>
+            </div>
+          </div>
+          <button
+            type="button"
+            onClick={() => onStartEncounterFromIntake?.(pendingIntakes[0])}
+            className="px-4 py-2.5 bg-emerald-500 hover:bg-emerald-400 text-slate-950 font-bold text-xs rounded-xl transition flex items-center justify-center gap-2 shadow-sm shrink-0"
+          >
+            <Stethoscope className="w-4 h-4 text-slate-950" />
+            <span>Call Patient &amp; 1-Click Import to SOAP</span>
+          </button>
+        </div>
+      )}
+
       {/* Hospital Sub-Header Bar */}
       <div className="flex flex-col sm:flex-row sm:items-center justify-between gap-4 bg-white border border-slate-200/90 p-4 rounded-xl shadow-xs">
         <div className="flex flex-wrap items-center gap-3">

src/components/charting/RadiographPostureViewer.tsx

@@ -0,0 +1,280 @@
+'use client';
+
+import React, { useState } from 'react';
+import { Eye, CheckCircle2, Sparkles, Layers, Activity } from 'lucide-react';
+import { clinicalAudio } from '@/lib/clinical-audio';
+
+interface RadiographPostureViewerProps {
+  onAppendObjective: (findingsText: string) => void;
+  readOnly?: boolean;
+}
+
+interface RadiographStudy {
+  id: string;
+  title: string;
+  modality: 'Digital Radiograph (X-Ray)' | 'Posture Grid' | 'MRI Scan';
+  region: 'Cervical Spine' | 'Lumbar Spine' | 'Full Spine Posture';
+  cobbAngle?: string;
+  georgesLine?: string;
+  discSpace?: string;
+  findings: string;
+  sampleSvg: React.ReactNode;
+}
+
+export const RadiographPostureViewer: React.FC<RadiographPostureViewerProps> = ({
+  onAppendObjective,
+  readOnly = false,
+}) => {
+  const [activeStudyId, setActiveStudyId] = useState<string>('cervical-lat');
+  const [showOverlays, setShowOverlays] = useState<boolean>(true);
+  const [importedToast, setImportedToast] = useState<boolean>(false);
+
+  const studies: RadiographStudy[] = [
+    {
+      id: 'cervical-lat',
+      title: 'Lateral Cervical Neutral Radiograph',
+      modality: 'Digital Radiograph (X-Ray)',
+      region: 'Cervical Spine',
+      cobbAngle: 'Hypolordosis (12° vs 35° normal)',
+      georgesLine: 'Mild step-off C3-C4 (1.5mm retrolisthesis)',
+      discSpace: 'C5-C6 anterior height loss ~25%',
+      findings:
+        'Radiological Evaluation: Lateral cervical spine film demonstrates marked loss of normal cervical lordosis (military neck appearance). Preserved vertebral body heights throughout C2-C7. Segmental retrolisthesis of C3 on C4 (~1.5mm). Disc space narrowing with mild osteophytic spurring noted at C5-C6 interspace. George\'s line intact without fracture.',
+      sampleSvg: (
+        <svg viewBox="0 0 300 380" className="w-full h-full max-h-[260px] bg-slate-950 rounded-lg select-none">
+          <defs>
+            <radialGradient id="xrayGlow" cx="50%" cy="50%" r="60%">
+              <stop offset="0%" stopColor="#1e293b" />
+              <stop offset="100%" stopColor="#020617" />
+            </radialGradient>
+            <linearGradient id="boneGrad" x1="0" y1="0" x2="1" y2="0">
+              <stop offset="0%" stopColor="#e2e8f0" stopOpacity="0.85" />
+              <stop offset="50%" stopColor="#f8fafc" stopOpacity="0.95" />
+              <stop offset="100%" stopColor="#94a3b8" stopOpacity="0.75" />
+            </linearGradient>
+          </defs>
+          <rect width="300" height="380" fill="url(#xrayGlow)" />
+
+          {showOverlays && (
+            <g stroke="#38bdf8" strokeWidth="1" strokeDasharray="3,3" opacity="0.8">
+              <line x1="140" y1="40" x2="140" y2="340" stroke="#f59e0b" strokeWidth="1.5" />
+              <path d="M 140,70 Q 155,180 140,290" fill="none" stroke="#38bdf8" strokeWidth="2" strokeDasharray="none" />
+              <text x="165" y="180" fill="#38bdf8" fontSize="10" fontFamily="monospace">12° Hypolordotic</text>
+              <text x="145" y="55" fill="#f59e0b" fontSize="9" fontFamily="monospace">George's Line</text>
+            </g>
+          )}
+
+          <path d="M 90,40 Q 150,15 210,40" stroke="#64748b" strokeWidth="3" fill="none" opacity="0.6" />
+
+          {/* Cervical Vertebrae (C1 - C7) */}
+          <ellipse cx="145" cy="65" rx="34" ry="10" fill="url(#boneGrad)" stroke="#cbd5e1" strokeWidth="1" />
+          <text x="190" y="68" fill="#94a3b8" fontSize="9" fontFamily="sans-serif">C1 (Atlas)</text>
+
+          <path d="M 135,75 L 142,60 L 148,75 Z" fill="#cbd5e1" opacity="0.8" />
+          <rect x="125" y="80" width="38" height="18" rx="3" fill="url(#boneGrad)" stroke="#cbd5e1" />
+          <text x="175" y="93" fill="#94a3b8" fontSize="9">C2 (Axis)</text>
+
+          <rect x="127" y="112" width="37" height="17" rx="3" fill="url(#boneGrad)" stroke="#cbd5e1" />
+          <text x="175" y="125" fill="#94a3b8" fontSize="9">C3</text>
+
+          <rect x="130" y="142" width="37" height="17" rx="3" fill="url(#boneGrad)" stroke="#cbd5e1" />
+          <text x="175" y="155" fill="#94a3b8" fontSize="9">C4</text>
+
+          <rect x="133" y="172" width="38" height="17" rx="3" fill="url(#boneGrad)" stroke="#cbd5e1" />
+          <text x="175" y="185" fill="#94a3b8" fontSize="9">C5</text>
+
+          <rect x="134" y="196" width="38" height="17" rx="3" fill="url(#boneGrad)" stroke="#f43f5e" strokeWidth="1.5" />
+          <text x="175" y="209" fill="#f43f5e" fontSize="9" fontWeight="bold">C6 (Narrowed)</text>
+
+          <rect x="135" y="226" width="40" height="19" rx="3" fill="url(#boneGrad)" stroke="#cbd5e1" />
+          <text x="180" y="240" fill="#94a3b8" fontSize="9">C7</text>
+
+          <rect x="133" y="258" width="44" height="20" rx="3" fill="url(#boneGrad)" stroke="#cbd5e1" opacity="0.8" />
+          <text x="185" y="272" fill="#64748b" fontSize="9">T1</text>
+        </svg>
+      ),
+    },
+    {
+      id: 'lumbar-ap',
+      title: 'AP & Lateral Lumbar Decompression Series',
+      modality: 'Digital Radiograph (X-Ray)',
+      region: 'Lumbar Spine',
+      cobbAngle: 'Right Dextroscoliosis 8° Apex L2',
+      georgesLine: 'Posterior vertebral alignment intact',
+      discSpace: 'L4-L5 disc height reduced 30%',
+      findings:
+        'Radiological Evaluation: Standing AP/lateral lumbar spine study reveals 8-degree dextroscoliosis centered at L2. Grade I degenerative disc disease at L4-L5 with 30% anterior-superior intervertebral disc collapse and reactive endplate sclerosis. Sacral base level within 2mm. Pedicles and transverse processes intact bilaterally.',
+      sampleSvg: (
+        <svg viewBox="0 0 300 380" className="w-full h-full max-h-[260px] bg-slate-950 rounded-lg select-none">
+          <defs>
+            <radialGradient id="lumbarGlow" cx="50%" cy="50%" r="60%">
+              <stop offset="0%" stopColor="#1e293b" />
+              <stop offset="100%" stopColor="#020617" />
+            </radialGradient>
+            <linearGradient id="lBoneGrad" x1="0" y1="0" x2="1" y2="0">
+              <stop offset="0%" stopColor="#e2e8f0" />
+              <stop offset="100%" stopColor="#94a3b8" />
+            </linearGradient>
+          </defs>
+          <rect width="300" height="380" fill="url(#lumbarGlow)" />
+
+          {showOverlays && (
+            <g stroke="#38bdf8" strokeWidth="1" strokeDasharray="3,3" opacity="0.8">
+              <line x1="150" y1="30" x2="150" y2="350" stroke="#f59e0b" strokeWidth="1.5" />
+              <path d="M 150,50 Q 165,140 150,260" fill="none" stroke="#38bdf8" strokeWidth="2" strokeDasharray="none" />
+              <text x="175" y="140" fill="#38bdf8" fontSize="10" fontFamily="monospace">8° Scoliosis</text>
+            </g>
+          )}
+
+          <rect x="125" y="45" width="48" height="25" rx="4" fill="url(#lBoneGrad)" stroke="#cbd5e1" />
+          <text x="180" y="62" fill="#94a3b8" fontSize="9">L1</text>
+
+          <rect x="127" y="82" width="50" height="26" rx="4" fill="url(#lBoneGrad)" stroke="#cbd5e1" />
+          <text x="185" y="99" fill="#94a3b8" fontSize="9">L2 (Apex)</text>
+
+          <rect x="126" y="120" width="52" height="27" rx="4" fill="url(#lBoneGrad)" stroke="#cbd5e1" />
+          <text x="185" y="137" fill="#94a3b8" fontSize="9">L3</text>
+
+          <rect x="124" y="158" width="54" height="28" rx="4" fill="url(#lBoneGrad)" stroke="#cbd5e1" />
+          <text x="185" y="175" fill="#94a3b8" fontSize="9">L4</text>
+
+          <rect x="122" y="196" width="56" height="28" rx="4" fill="url(#lBoneGrad)" stroke="#f43f5e" strokeWidth="1.5" />
+          <text x="185" y="213" fill="#f43f5e" fontSize="9" fontWeight="bold">L5 (Disc Loss)</text>
+
+          <path d="M 115,235 L 185,235 L 170,295 L 130,295 Z" fill="#64748b" opacity="0.85" />
+          <path d="M 75,235 Q 115,220 115,260 Q 95,290 75,260 Z" fill="#475569" opacity="0.6" />
+          <path d="M 225,235 Q 185,220 185,260 Q 205,290 225,260 Z" fill="#475569" opacity="0.6" />
+          <text x="135" y="265" fill="#e2e8f0" fontSize="10" fontWeight="bold">Sacrum</text>
+        </svg>
+      ),
+    },
+  ];
+
+  const currentStudy = studies.find((s) => s.id === activeStudyId) || studies[0];
+
+  const handleImportToObjective = () => {
+    clinicalAudio.playSuccess();
+    onAppendObjective(currentStudy.findings);
+    setImportedToast(true);
+    setTimeout(() => setImportedToast(false), 3500);
+  };
+
+  return (
+    <div className="bg-white border border-slate-200 rounded-xl p-5 shadow-xs text-slate-800">
+      {/* Header Bar */}
+      <div className="flex flex-col sm:flex-row sm:items-center justify-between gap-3 pb-3 border-b border-slate-100">
+        <div className="flex items-center gap-2.5">
+          <span className="p-1.5 rounded-lg bg-sky-50 text-sky-700 border border-sky-100">
+            <Activity className="w-4 h-4" />
+          </span>
+          <div>
+            <h4 className="font-bold text-slate-900 text-sm tracking-tight">
+              Radiograph &amp; Posture Film Analyzer (DICOM Viewer)
+            </h4>
+            <p className="text-xs text-slate-500">
+              Correlate anatomical palpations with radiological curvature &amp; disc height measurements.
+            </p>
+          </div>
+        </div>
+
+        <div className="flex items-center gap-2">
+          <button
+            type="button"
+            onClick={() => setShowOverlays(!showOverlays)}
+            className={`px-3 py-1.5 rounded-lg text-xs font-bold flex items-center gap-1.5 transition border ${
+              showOverlays
+                ? 'bg-sky-50 text-sky-800 border-sky-200'
+                : 'bg-slate-100 text-slate-600 border-slate-200 hover:bg-slate-200'
+            }`}
+          >
+            <Layers className="w-3.5 h-3.5" />
+            {showOverlays ? 'Anatomical Calipers: ON' : 'Anatomical Calipers: OFF'}
+          </button>
+        </div>
+      </div>
+
+      {/* Studies Tab Selector */}
+      <div className="flex items-center gap-2 mt-4 overflow-x-auto pb-1 text-xs">
+        {studies.map((s) => (
+          <button
+            key={s.id}
+            type="button"
+            onClick={() => setActiveStudyId(s.id)}
+            className={`px-3 py-1.5 rounded-lg font-bold transition flex items-center gap-1.5 whitespace-nowrap ${
+              activeStudyId === s.id
+                ? 'bg-slate-900 text-white shadow-xs'
+                : 'bg-slate-100 text-slate-600 hover:bg-slate-200'
+            }`}
+          >
+            <Eye className="w-3.5 h-3.5" />
+            {s.title}
+          </button>
+        ))}
+      </div>
+
+      {/* Main Study Inspection Box */}
+      <div className="grid grid-cols-1 lg:grid-cols-12 gap-5 mt-4">
+        {/* Left 5 Cols: Radiograph Film Simulation */}
+        <div className="lg:col-span-5 flex flex-col items-center justify-center p-3 bg-slate-950 rounded-xl border border-slate-800 shadow-inner">
+          {currentStudy.sampleSvg}
+          <div className="w-full mt-2 pt-2 border-t border-slate-800 flex items-center justify-between text-[11px] text-slate-400 font-mono">
+            <span>PACS ID: RAD-2026-0907</span>
+            <span className="text-emerald-400 font-bold">100% High-Res Film</span>
+          </div>
+        </div>
+
+        {/* Right 7 Cols: Clinical Findings & Measurements */}
+        <div className="lg:col-span-7 flex flex-col justify-between space-y-4">
+          <div className="space-y-3">
+            <div className="bg-slate-50 p-3.5 rounded-xl border border-slate-200 space-y-2 text-xs">
+              <div className="font-bold text-slate-900 flex items-center gap-2">
+                <span>Radiological Measurements</span>
+                <span className="text-[10px] bg-sky-100 text-sky-800 px-2 py-0.5 rounded font-mono font-bold">
+                  {currentStudy.region}
+                </span>
+              </div>
+              <div className="grid grid-cols-2 gap-2 pt-1 font-mono text-[11px]">
+                <div className="bg-white p-2 rounded border border-slate-200">
+                  <span className="text-slate-500 block text-[10px]">Cobb Angle / Arc:</span>
+                  <strong className="text-sky-900">{currentStudy.cobbAngle}</strong>
+                </div>
+                <div className="bg-white p-2 rounded border border-slate-200">
+                  <span className="text-slate-500 block text-[10px]">Intervertebral Spacing:</span>
+                  <strong className="text-rose-700">{currentStudy.discSpace}</strong>
+                </div>
+              </div>
+            </div>
+
+            <div className="bg-slate-50 p-3.5 rounded-xl border border-slate-200 space-y-1.5 text-xs">
+              <span className="font-bold text-slate-900 block">Clinician Radiological Narrative:</span>
+              <p className="text-slate-700 font-mono text-[11px] leading-relaxed bg-white p-2.5 rounded-lg border border-slate-200 select-text">
+                {currentStudy.findings}
+              </p>
+            </div>
+          </div>
+
+          {/* Action Row */}
+          <div>
+            {!readOnly && (
+              <button
+                type="button"
+                onClick={handleImportToObjective}
+                className="w-full py-2.5 px-4 bg-sky-700 hover:bg-sky-800 text-white font-bold text-xs rounded-xl transition shadow-xs flex items-center justify-center gap-2"
+              >
+                <Sparkles className="w-4 h-4 text-sky-200" />
+                <span>Import Radiograph Findings to Objective SOAP Note</span>
+              </button>
+            )}
+
+            {importedToast && (
+              <div className="mt-2 p-2.5 bg-emerald-50 border border-emerald-200 rounded-lg text-xs text-emerald-800 font-medium flex items-center gap-2 animate-in fade-in duration-200">
+                <CheckCircle2 className="w-4 h-4 text-emerald-600 shrink-0" />
+                <span>Radiological measurements and narrative auto-appended to Objective clinical findings.</span>
+              </div>
+            )}
+          </div>
+        </div>
+      </div>
+    </div>
+  );
+};

src/components/charting/SoapChartEditor.tsx

@@ -11,6 +11,7 @@ import {
   ClinicalDiscipline,
 } from '@/types/clinical';
 import { SpineVisualizer } from '@/components/ui/SpineVisualizer';
+import { RadiographPostureViewer } from './RadiographPostureViewer';
 import { AmbientAudioRecorder } from '@/components/ui/AmbientAudioRecorder';
 import { PatientClinicalHud } from '@/components/ui/PatientClinicalHud';
 import { clinicalAudio } from '@/lib/clinical-audio';
@@ -91,8 +92,11 @@ export const SoapChartEditor: React.FC<SoapChartEditorProps> = ({
   const [signedTimestamp, setSignedTimestamp] = useState<string | undefined>(initialSoapNote?.signedAt);
   const [lastAutoSaved, setLastAutoSaved] = useState<string | null>(null);
   const [aiModelUsed, setAiModelUsed] = useState<string | null>(null);
+  const [imagingMode, setImagingMode] = useState<'spine' | 'radiograph'>('spine');
 
-  // Sync and restore state when patient or active note changes
+  const handleAppendObjectiveFindings = (findingsText: string) => {
+    setObjective((prev) => (prev ? `${prev}\n\n${findingsText}` : findingsText));
+  };
   useEffect(() => {
     if (initialSoapNote) {
       setDiscipline(initialSoapNote.discipline || 'chiropractic');
@@ -574,12 +578,51 @@ export const SoapChartEditor: React.FC<SoapChartEditorProps> = ({
         </div>
       )}
 
-      {/* Spine Subluxation Visualizer (shown prominently for chiropractic & physical therapy) */}
+      {/* Anatomical Imaging & Palpation Mode Switcher */}
+      <div className="flex items-center justify-between bg-slate-100 p-1 rounded-xl border border-slate-200 text-xs">
+        <div className="flex items-center gap-1">
+          <button
+            type="button"
+            onClick={() => setImagingMode('spine')}
+            className={`px-3 py-1.5 rounded-lg font-bold transition flex items-center gap-1.5 ${
+              imagingMode === 'spine'
+                ? 'bg-white text-sky-900 shadow-xs border border-slate-200'
+                : 'text-slate-600 hover:text-slate-900'
+            }`}
+          >
+            <span>🦴</span>
+            <span>2D Spine Subluxation Mapper</span>
+          </button>
+          <button
+            type="button"
+            onClick={() => setImagingMode('radiograph')}
+            className={`px-3 py-1.5 rounded-lg font-bold transition flex items-center gap-1.5 ${
+              imagingMode === 'radiograph'
+                ? 'bg-white text-sky-900 shadow-xs border border-slate-200'
+                : 'text-slate-600 hover:text-slate-900'
+            }`}
+          >
+            <span>🩻</span>
+            <span>Digital X-Ray &amp; Posture Film Analyzer (DICOM)</span>
+          </button>
+        </div>
+        <span className="text-[10px] font-mono text-slate-500 pr-2 hidden sm:inline">
+          {imagingMode === 'spine' ? 'Interactive Tactile Listings' : 'Anatomical Calipers & Cobb Angle'}
+        </span>
+      </div>
+
+      {imagingMode === 'spine' ? (
         <SpineVisualizer
           adjustments={adjustments}
           onToggleAdjustment={handleToggleAdjustment}
           readOnly={isSigned}
         />
+      ) : (
+        <RadiographPostureViewer
+          onAppendObjective={handleAppendObjectiveFindings}
+          readOnly={isSigned}
+        />
+      )}
 
       {/* Structured SOAP Fields */}
       <div className="grid grid-cols-1 md:grid-cols-2 gap-5">

src/components/ui/AmbientAudioRecorder.tsx

@@ -1,8 +1,9 @@
 'use client';
 
-import React, { useState, useEffect } from 'react';
+import React, { useState, useEffect, useRef } from 'react';
-import { Mic, MicOff, Sparkles, Volume2, CheckCircle2, ShieldCheck } from 'lucide-react';
+import { Mic, MicOff, Sparkles, Volume2, CheckCircle2, ShieldCheck, Trash2, Radio } from 'lucide-react';
 import { SAMPLE_AUDIO_PRESETS } from '@/lib/mock-data';
+import { clinicalAudio } from '@/lib/clinical-audio';
 
 interface AmbientAudioRecorderProps {
   onApplyExtractedSoap: (soapData: {
@@ -26,8 +27,10 @@ export const AmbientAudioRecorder: React.FC<AmbientAudioRecorderProps> = ({
   const [selectedPreset, setSelectedPreset] = useState(SAMPLE_AUDIO_PRESETS[0]);
   const [isProcessingAI, setIsProcessingAI] = useState(false);
   const [liveTranscript, setLiveTranscript] = useState('');
+  const [isHardwareMicActive, setIsHardwareMicActive] = useState(false);
   const [showAppliedToast, setShowAppliedToast] = useState(false);
   const [selectedModel, setSelectedModel] = useState<'gpt-5.4' | 'claude-3.7-sonnet' | 'gemini-2.5-pro'>('gpt-5.4');
+  const recognitionRef = useRef<any>(null);
 
   useEffect(() => {
     let interval: any = null;
@@ -42,16 +45,84 @@ export const AmbientAudioRecorder: React.FC<AmbientAudioRecorderProps> = ({
   }, [isRecording]);
 
   const toggleRecording = () => {
+    clinicalAudio.playClick();
     if (!isRecording) {
       setIsRecording(true);
       setRecordingSeconds(0);
-      setLiveTranscript('Operatory Microphone Live... Listening to clinician-patient dialogue.');
+
+      const SpeechRecognition =
+        typeof window !== 'undefined'
+          ? (window as any).SpeechRecognition || (window as any).webkitSpeechRecognition
+          : null;
+
+      if (SpeechRecognition) {
+        try {
+          const recognition = new SpeechRecognition();
+          recognition.continuous = true;
+          recognition.interimResults = true;
+          recognition.lang = 'en-US';
+
+          let accumulated = '';
+          recognition.onresult = (event: any) => {
+            let interim = '';
+            for (let i = event.resultIndex; i < event.results.length; i++) {
+              const transcriptPiece = event.results[i][0].transcript;
+              if (event.results[i].isFinal) {
+                accumulated += (accumulated ? ' ' : '') + transcriptPiece;
+              } else {
+                interim += transcriptPiece;
+              }
+            }
+            setLiveTranscript(accumulated + (interim ? ' ' + interim : ''));
+            setIsHardwareMicActive(true);
+          };
+
+          recognition.onerror = (e: any) => {
+            console.warn('SpeechRecognition error or fallback:', e);
+            if (!liveTranscript) {
+              setLiveTranscript(selectedPreset.audioTranscript);
+            }
+          };
+
+          recognition.onend = () => {
+            if (recognitionRef.current && isRecording) {
+              try {
+                recognition.start();
+              } catch {}
+            }
+          };
+
+          recognition.start();
+          recognitionRef.current = recognition;
+          setIsHardwareMicActive(true);
+          setLiveTranscript('Operatory Microphone Connected. Speak naturally into your device...');
+        } catch (err) {
+          console.warn('Failed to start SpeechRecognition:', err);
+          setIsHardwareMicActive(false);
+          setLiveTranscript(selectedPreset.audioTranscript);
+        }
+      } else {
+        setIsHardwareMicActive(false);
+        setLiveTranscript('Operatory Microphone active. Capturing encounter dialogue...');
         setTimeout(() => {
           setLiveTranscript(selectedPreset.audioTranscript);
-      }, 2500);
+        }, 1500);
+      }
     } else {
       setIsRecording(false);
+      if (recognitionRef.current) {
+        try {
+          recognitionRef.current.stop();
+        } catch {}
+        recognitionRef.current = null;
       }
+      setIsHardwareMicActive(false);
+    }
+  };
+
+  const handleClearTranscript = () => {
+    clinicalAudio.playClick();
+    setLiveTranscript('');
   };
 
   const handleSelectPreset = (preset: typeof SAMPLE_AUDIO_PRESETS[0]) => {
@@ -65,15 +136,55 @@ export const AmbientAudioRecorder: React.FC<AmbientAudioRecorderProps> = ({
     setIsProcessingAI(true);
     setTimeout(() => {
       setIsProcessingAI(false);
+
+      const transcriptText = (liveTranscript || selectedPreset.audioTranscript).trim();
+      const hasCustomSpokenContent =
+        isHardwareMicActive &&
+        transcriptText.length > 20 &&
+        transcriptText !== selectedPreset.audioTranscript;
+
+      let extractedData: any;
+
+      if (hasCustomSpokenContent) {
+        const lower = transcriptText.toLowerCase();
+        let detectedVas = 4;
+        const vasMatch = lower.match(/(?:pain|vas|rated|score|level)\s*(?:is|at|of)?\s*(\d{1,2})(?:\/10)?/i);
+        if (vasMatch && vasMatch[1]) {
+          const num = parseInt(vasMatch[1], 10);
+          if (num >= 0 && num <= 10) detectedVas = num;
+        }
+
+        const isCervical = lower.includes('neck') || lower.includes('cervical') || lower.includes('headache') || lower.includes('c1') || lower.includes('c2') || lower.includes('c5');
+        const isLumbar = lower.includes('low back') || lower.includes('lumbar') || lower.includes('sciatica') || lower.includes('l4') || lower.includes('l5') || lower.includes('sacroiliac');
+
+        extractedData = {
+          vasScore: detectedVas,
+          subjective: `Patient encounter captured via live operatory microphone: "${transcriptText}". Patient reports symptom exacerbation with functional limitations. Current pain severity rated at ${detectedVas}/10.`,
+          objective: isCervical
+            ? 'Cervical ROM restricted in rotation and lateral flexion. Palpation demonstrates segmental fixation at C1-C2 and C5-C6 with hypertonicity in suboccipital and levator scapulae musculature.'
+            : 'Lumbar active ROM: Flexion restricted to 65 deg with pain, extension 12 deg. Palpation demonstrates severe segmental fixations at L4-L5 and right sacroiliac joint. Antalgic guarding noted in right quadratus lumborum.',
+          assessment: isCervical
+            ? 'Segmental and somatic dysfunction of cervical region (M99.01) with cervicogenic tension. Favorable response to clinical spinal manipulation.'
+            : 'Segmental and somatic dysfunction of lumbar spine (M99.03) and pelvic region (M99.05). Subluxation complex stabilizing under ongoing care protocol.',
+          plan: '1. High velocity low amplitude (HVLA) Diversified spinal manipulation delivered to indicated segments.\n2. Manual myofascial release and targeted therapeutic stretching (15 min).\n3. Prescribed core stabilization and home postural resets.\n4. Re-evaluate in 3 days.',
+          spinalAdjustments: isCervical
+            ? [
+                { vertebra: 'C1 (Atlas)', region: 'Cervical', listing: 'Right Lateral Mass Anterior', technique: 'Diversified', notes: 'Audible cavitation, immediate release' },
+                { vertebra: 'C5', region: 'Cervical', listing: 'Posterior Right', technique: 'Diversified', notes: 'Manual adjustment delivered' },
+              ]
+            : [
+                { vertebra: 'L4', region: 'Lumbar', listing: 'Right Mamillary Posterior (RP)', technique: 'Diversified', notes: 'Audible cavitation, antalgic guarding reduced' },
+                { vertebra: 'Sacrum', region: 'Pelvis/Sacrum', listing: 'Right Sacral Base Anterior', technique: 'Thompson Drop', notes: 'Double drop piece protocol' },
+              ],
+          icd10: isCervical ? ['M99.01', 'M54.2'] : ['M99.03', 'M99.05', 'M54.50'],
+          cpt: ['98940', '97140'],
+        };
+      } else {
+        extractedData = selectedPreset.extractedSOAP;
+      }
+
       onApplyExtractedSoap({
-        vasScore: selectedPreset.extractedSOAP.vasScore,
+        ...extractedData,
-        subjective: selectedPreset.extractedSOAP.subjective,
-        objective: selectedPreset.extractedSOAP.objective,
-        assessment: selectedPreset.extractedSOAP.assessment,
-        plan: selectedPreset.extractedSOAP.plan,
-        spinalAdjustments: selectedPreset.extractedSOAP.spinalAdjustments as any,
-        icd10: selectedPreset.extractedSOAP.icd10,
-        cpt: selectedPreset.extractedSOAP.cpt,
         modelUsed: selectedModel,
       });
       setShowAppliedToast(true);
@@ -269,8 +380,33 @@ export const AmbientAudioRecorder: React.FC<AmbientAudioRecorderProps> = ({
         <div className="md:col-span-8 bg-slate-50 border border-slate-200 rounded-lg p-3.5 flex flex-col justify-between">
           <div>
             <div className="flex items-center justify-between pb-2 border-b border-slate-200 text-xs">
+              <div className="flex items-center gap-2">
                 <span className="font-bold text-slate-800">Transcript Log</span>
-              <span className="text-[11px] text-slate-500 font-mono">Live Operatory Mic</span>
+                {isHardwareMicActive ? (
+                  <span className="inline-flex items-center gap-1 text-[10px] font-bold text-emerald-700 bg-emerald-50 px-2 py-0.5 rounded border border-emerald-200">
+                    <Radio className="w-3 h-3 text-emerald-600 animate-pulse" />
+                    Live Hardware Mic Streaming
+                  </span>
+                ) : (
+                  <span className="text-[10px] font-mono text-slate-500 bg-slate-100 px-2 py-0.5 rounded">
+                    Operatory Mic Mode
+                  </span>
+                )}
+              </div>
+              <div className="flex items-center gap-2">
+                {liveTranscript && (
+                  <button
+                    type="button"
+                    onClick={handleClearTranscript}
+                    className="text-[10px] text-slate-400 hover:text-red-600 flex items-center gap-1 transition"
+                    title="Clear Transcript"
+                  >
+                    <Trash2 className="w-3 h-3" />
+                    Clear
+                  </button>
+                )}
+                <span className="text-[11px] text-slate-500 font-mono">Web Speech v2.6</span>
+              </div>
             </div>
             <p className="text-xs text-slate-700 whitespace-pre-line mt-2 font-mono leading-relaxed max-h-[160px] overflow-y-auto pr-1">
               {liveTranscript || selectedPreset.audioTranscript}