fixed payer name and plan identifier

resources/views/app/patient/client-primary-coverages.blade.php

@@ -101,13 +101,10 @@
                         </select>
                     </div>
                     <div class="form-group">
-                        <label for="" class="control-label">Plan Name</label>
-                        <input type="text" name="planName" class="form-control input-sm">
-                    </div>
-                    <div class="form-group">
-                        <label for="" class="control-label">Plan Identifier</label>
-                        <input type="text" name="planIdentifier" class="form-control input-sm">
+                        <label for="" class="control-label">Payer Name</label>
+                        <input type="text" name="payerName" class="form-control input-sm">
                     </div>
+                   
                     <div class="form-group text-nowrap mb-0">
                         <button class="btn btn-sm btn-primary" submit>Submt</button>
                         <button class="btn btn-sm btn-default border" close>Close</button>
@@ -148,13 +145,10 @@
                         </select>
                     </div>
                     <div class="form-group">
-                        <label class="control-label">Plan Name</label>
-                        <input type="text" name="planName" class="form-control input-sm">
-                    </div>
-                    <div class="form-group">
-                        <label class="control-label">Plan Identifier</label>
-                        <input type="text" name="planIdentifier" class="form-control input-sm">
+                        <label class="control-label">Payer Name</label>
+                        <input type="text" name="payerName" class="form-control input-sm">
                     </div>
+                    
                     <div class="form-group text-nowrap mb-0">
                         <button class="btn btn-sm btn-primary" submit>Submt</button>
                         <button class="btn btn-sm btn-default border" close>Close</button>
@@ -390,13 +384,10 @@
                         </select>
                     </div>
                     <div class="form-group">
-                        <label for="" class="control-label">Plan Name</label>
-                        <input type="text" name="planName" class="form-control input-sm"/>
-                    </div>
-                    <div class="form-group">
-                        <label for="" class="control-label">Plan Identifier</label>
-                        <input type="text" name="planIdentifier" class="form-control input-sm"/>
+                        <label for="" class="control-label">Payer Name</label>
+                        <input type="text" name="payerName" class="form-control input-sm"/>
                     </div>
+                   
                     <div class="form-group">
                         <label for="" class="control-label">Manual Determination Strategy</label>
                         <select  name="manualDeterminationStrategy" class="form-control input-sm">
@@ -448,8 +439,7 @@
                 <th>Subscriber Sex</th>
                 <th>Subscriber Dob</th>
                 <th>Payer Member Identifier</th>
-                <th>Plan Name</th>
-                <th>Plan Identifier</th>
+                <th>Payer Name</th>
                 <th>Date Of Service</th>
                 <th>Auto Is Payer Member Identifier Valid</th>
                 <th>Auto Detail Json</th>