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@@ -23,7 +23,7 @@ $medicaidStates = Config::get('constants.medicaid_states');
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<div class="alert alert-danger">{{ session('message') }}</div>
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@endif
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<div class="row">
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- <div class="col-md-5">
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+ <div class="border-lighter col-md-5">
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<div class="row">
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<div class="col-md-12 bg-light p-3 mb-2">
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<h5 class="m-0 font-weight-bold">Patient Name / Demographics:</h5>
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@@ -258,11 +258,11 @@ $medicaidStates = Config::get('constants.medicaid_states');
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</div>
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<div class="row" v-if="planType == 'MEDICAID' || planType == 'COMMERCIAL'" :class="planType == 'COMMERCIAL' ? 'mx-0' : ''">
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<div class="col-md-12">
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- <div class="bg-light p-1 mb-2">
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+ <div class="bg-light p-2 mb-2">
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<h5 class="m-0 font-weight-bold">Medicaid Information:</h5>
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</div>
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</div>
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- <div class="col-12">
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+ <div class="col-12 px-0">
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<div class="px-2">
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<div class="form-group col-md-6">
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<label for="" class="control-label">Medicaid State</label>
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@@ -285,11 +285,11 @@ $medicaidStates = Config::get('constants.medicaid_states');
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<div class="row" v-if="planType == 'MEDICARE' || planType == 'COMMERCIAL'" :class="planType == 'COMMERCIAL' ? 'mx-0' : ''">
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<div class="col-md-12">
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- <div class="bg-light p-1 mb-2">
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+ <div class="bg-light p-2 mb-2">
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<h5 class="m-0 font-weight-bold">Medicare Information:</h5>
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</div>
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</div>
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- <div class="col-12">
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+ <div class="col-12 px-0">
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<div class="px-2">
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<div class="form-group col-md-6">
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<label class="control-label">Medicare Number</label>
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