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@@ -38,7 +38,7 @@
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<div class="ml-auto d-inline-flex justify-content-center">
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<span class="mr-2">New w/o Manual:</span>
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<div moe relative large>
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- <a href="" start show>+ MC</a>
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+ <a href="" start show>+ MCR</a>
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<form url="/api/clientPrimaryCoverage/createNewCoverageForMedicareWithoutManualDetermination" right class="mcp-theme-1">
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<input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
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<div class="form-group">
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@@ -249,567 +249,11 @@
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</form>
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</div>
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</div>
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- <div class="ml-4 d-inline-flex justify-content-center">
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- <span class="mr-2">New w/ Manual:</span>
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- <div moe relative large>
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- <a href="" start show >+ MC</a>
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- <form url="/api/clientPrimaryCoverage/createNewCoverageForMedicareWithManualDetermination" right class="mcp-theme-1">
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- <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
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- <div class="form-group">
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- <label for="" class="control-label">Subscriber Name First</label>
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- <input type="text" name="subscriberNameFirst" class="form-control input-sm" value="{{$patient->name_first}}"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Subscriber Name Last</label>
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- <input type="text" name="subscriberNameLast" class="form-control input-sm" value="{{$patient->name_last}}"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Subscriber Dob</label>
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- <input type="date" name="subscriberDob" class="form-control input-sm" value="{{$patient->dob}}"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Payer Member Identifier</label>
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- <input type="text" name="payerMemberIdentifier" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Date Of Service</label>
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- <input type="date" name="dateOfService" class="form-control input-sm" value="{{date('Y-m-d')}}"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Strategy</label>
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- <select name="manualDeterminationStrategy" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="REVIEWED_ELECTRONIC">Reviewed electronic</option>
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- <option value="CALLED_PAYER">Called payer</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Category</label>
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- <select name="manualDeterminationCategory" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="COVERED">Covered</option>
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- <option value="NOT_COVERED">Not Covered</option>
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- <option value="INVALID">Invalid</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Category Memo</label>
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- <input type="text" name="manualDeterminationCategoryMemo" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Detail Json</label>
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- <input type="text" name="manualDetailJson" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Is Part B Primary</label>
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- <select name="manualMedicareIsPartBPrimary" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Is Part B Active</label>
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- <select name="manualMedicareIsPartBActive" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Is Part C Active</label>
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- <select name="manualMedicareIsPartCActive" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Is Inpatient</label>
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- <select name="manualMedicareIsInpatient" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Is Hospice Or Home Health</label>
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- <select name="manualMedicareIsHospiceOrHomeHealth" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Is Msp</label>
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- <select name="manualMedicareIsMsp" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Msp Memo</label>
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- <select name="manualMedicareMspMemo" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="YES">Yes</option>
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- <option value="NO">No</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Start Date</label>
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- <input type="date" name="manualMedicareMpbStartDate" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb End Date</label>
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- <input type="date" name="manualMedicareMpbEndDate" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Deductible</label>
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- <input type="number" name="manualMedicareMpbDeductible" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Remaining</label>
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- <input type="number" name="manualMedicareMpbRemaining" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Insurance Type</label>
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- <input type="text" name="manualMedicareMpbInsuranceType" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Insurance Type Label</label>
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- <input type="text" name="manualMedicareMpbInsuranceTypeLabel" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Coinsurance Percent</label>
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- <input type="number" name="manualMedicareMpbCoinsurancePercent" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Info Valid Until</label>
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- <input type="date" name="manualMedicareMpbInfoValidUntil" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Medicare Mpb Info Valid Till</label>
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- <input type="date" name="manualMedicareMpbInfoValidTill" class="form-control input-sm"/>
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- </div>
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- <div class="form-group text-nowrap mb-0">
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- <button class="btn btn-sm btn-primary" submit>Submt</button>
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- <button class="btn btn-sm btn-default border" close>Close</button>
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- </div>
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- </form>
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- </div>
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- <span class="mx-2 text-secondary text-sm">|</span>
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- <div moe relative large>
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- <a href="" start show >+ Medicaid</a>
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- <form url="/api/clientPrimaryCoverage/createNewCoverageForMedicaidWithManualDetermination" right class="mcp-theme-1">
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- <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Strategy</label>
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- <select name="manualDeterminationStrategy" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="REVIEWED_ELECTRONIC">Reviewed electronic</option>
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- <option value="CALLED_PAYER">Called payer</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Category</label>
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- <select name="manualDeterminationCategory" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="COVERED">Covered</option>
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- <option value="NOT_COVERED">Not Covered</option>
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- <option value="INVALID">Invalid</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="form-control-label">Manual Determination Category Memo</label>
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- <input type="text" name="manualDeterminationCategoryMemo" class="form-control input-sm">
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Detail Json</label>
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- <input type="text" name="manualDetailJson" class="form-control input-sm">
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- </div>
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- <div class="form-group text-nowrap mb-0">
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- <button class="btn btn-sm btn-primary" submit>Submt</button>
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- <button class="btn btn-sm btn-default border" close>Close</button>
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- </div>
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- </form>
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- </div>
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- <span class="mx-2 text-secondary text-sm">|</span>
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- <div moe relative large>
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- <a href="" start show >+ Comm.</a>
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- <form url="/api/clientPrimaryCoverage/createNewCoverageForCommercialWithManualDetermination" right class="mcp-theme-1">
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- <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
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- <div class="form-group">
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- <label class="control-label">Subscriber Name First</label>
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- <input type="text" name="subscriberNameFirst" class="form-control input-sm" value="{{$patient->name_first}}">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Subscriber Name Last</label>
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- <input type="text" name="subscriberNameLast" class="form-control input-sm" value="{{$patient->name_last}}">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Subscriber Dob</label>
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- <input type="date" name="subscriberDob" class="form-control input-sm" value="{{$patient->dob}}">
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Subscriber Sex</label>
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- <select name="subscriberSex" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="M" {{$patient->sex === 'M' ? 'selected' : ''}}>M</option>
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- <option value="F" {{$patient->sex === 'F' ? 'selected' : ''}}>F</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Payer Name</label>
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- <input type="text" name="payerName" class="form-control input-sm"/>
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- </div>
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- <div class="form-group">
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- <label class="control-label">Payer Member Identifier</label>
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- <input type="text" name="payerMemberIdentifier" class="form-control input-sm">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Date Of Service</label>
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- <input type="date" name="dateOfService" class="form-control input-sm" value="{{date('Y-m-d')}}">
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- </div>
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-
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Strategy</label>
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- <select name="manualDeterminationStrategy" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="REVIEWED_ELECTRONIC">Reviewed electronic</option>
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- <option value="CALLED_PAYER">Called payer</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Category</label>
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- <select name="manualDeterminationCategory" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="COVERED">Covered</option>
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- <option value="NOT_COVERED">Not Covered</option>
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- <option value="INVALID">Invalid</option>
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- <option value="UNKNOWN">Unknown</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Category Memo</label>
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- <textarea name="manualDeterminationCategoryMemo" class="form-control input-sm"></textarea>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Detail Json</label>
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- <textarea name="manualDetailJson" class="form-control input-sm"></textarea>
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- </div>
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- <div class="form-group text-nowrap mb-0">
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- <button class="btn btn-sm btn-primary" submit>Submt</button>
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- <button class="btn btn-sm btn-default border" close>Close</button>
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- </div>
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- </form>
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- </div>
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- <span class="mx-2 text-secondary text-sm">|</span>
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- <div moe relative large>
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- <a href="" start show >+ Mcr Adv.</a>
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- <form url="/api/clientPrimaryCoverage/createNewCoverageForMcrAdvWithManualDetermination" right class="mcp-theme-1">
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- <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
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- <div class="form-group">
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- <label class="control-label">Subscriber Name First</label>
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- <input type="text" name="subscriberNameFirst" class="form-control input-sm" value="{{$patient->name_first}}">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Subscriber Name Last</label>
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- <input type="text" name="subscriberNameLast" class="form-control input-sm" value="{{$patient->name_last}}">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Subscriber Dob</label>
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- <input type="date" name="subscriberDob" class="form-control input-sm" value="{{$patient->dob}}">
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Subscriber Sex</label>
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- <select name="subscriberSex" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="M" {{$patient->sex === 'M' ? 'selected' : ''}}>M</option>
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- <option value="F" {{$patient->sex === 'F' ? 'selected' : ''}}>F</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label class="control-label">Payer Member Identifier</label>
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- <input type="text" name="payerMemberIdentifier" class="form-control input-sm">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Medicare Number</label>
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- <input type="text" name="mcrNumber" class="form-control input-sm">
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- </div>
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- <div class="form-group">
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- <label class="control-label">Date Of Service</label>
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- <input type="date" name="dateOfService" class="form-control input-sm" value="{{date('Y-m-d')}}">
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- </div>
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-
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Strategy</label>
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- <select name="manualDeterminationStrategy" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="REVIEWED_ELECTRONIC">Reviewed electronic</option>
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- <option value="CALLED_PAYER">Called payer</option>
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- </select>
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- </div>
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- <div class="form-group">
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- <label for="" class="control-label">Manual Determination Category</label>
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- <select name="manualDeterminationCategory" class="form-control input-sm">
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- <option value="">--select--</option>
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- <option value="COVERED">Covered</option>
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- <option value="NOT_COVERED">Not Covered</option>
|
|
|
- <option value="INVALID">Invalid</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Determination Category Memo</label>
|
|
|
- <textarea name="manualDeterminationCategoryMemo" class="form-control input-sm"></textarea>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Detail Json</label>
|
|
|
- <textarea name="manualDetailJson" class="form-control input-sm"></textarea>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Is Payer Member Identifier Valid</label>
|
|
|
- <select name="manualIsPayerMemberIdentifierValid" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="YES">Yes</option>
|
|
|
- <option value="NO">No</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Is Mcr Number Valid</label>
|
|
|
- <select name="manualIsMcrNumberValid" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="YES">Yes</option>
|
|
|
- <option value="NO">No</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
-
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Is Mcr Part Bprimary</label>
|
|
|
- <select name="manualIsMcrPartBPrimary" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="YES">Yes</option>
|
|
|
- <option value="NO">No</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
-
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Is Mcr Part C Active</label>
|
|
|
- <select name="manualIsMcrPartCActive" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="YES">Yes</option>
|
|
|
- <option value="NO">No</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </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>
|
|
|
- </div>
|
|
|
- </form>
|
|
|
- </div>
|
|
|
-
|
|
|
- <span class="mx-2 text-secondary text-sm">|</span>
|
|
|
- <div moe relative large>
|
|
|
- <a href="" start show >+ Mcd Mco.</a>
|
|
|
- <form url="/api/clientPrimaryCoverage/createNewCoverageForMcdMcoWithManualDetermination" right class="mcp-theme-1">
|
|
|
- <input type="hidden" name="clientUid" value="{{$patient->uid}}" class="form-control input-sm" />
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Subscriber Name First</label>
|
|
|
- <input type="text" name="subscriberNameFirst" class="form-control input-sm" value="{{$patient->name_first}}">
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Subscriber Name Last</label>
|
|
|
- <input type="text" name="subscriberNameLast" class="form-control input-sm" value="{{$patient->name_last}}">
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Subscriber Dob</label>
|
|
|
- <input type="date" name="subscriberDob" class="form-control input-sm" value="{{$patient->dob}}">
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Subscriber Sex</label>
|
|
|
- <select name="subscriberSex" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="M" {{$patient->sex === 'M' ? 'selected' : ''}}>M</option>
|
|
|
- <option value="F" {{$patient->sex === 'F' ? 'selected' : ''}}>F</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Payer Member Identifier</label>
|
|
|
- <input type="text" name="payerMemberIdentifier" class="form-control input-sm">
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Medicaid Number</label>
|
|
|
- <input type="text" name="mcrNumber" class="form-control input-sm">
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Medicaid State</label>
|
|
|
- <input type="text" name="mcdState" class="form-control input-sm">
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label class="control-label">Date Of Service</label>
|
|
|
- <input type="date" name="dateOfService" class="form-control input-sm" value="{{date('Y-m-d')}}">
|
|
|
- </div>
|
|
|
-
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Determination Strategy</label>
|
|
|
- <select name="manualDeterminationStrategy" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="REVIEWED_ELECTRONIC">Reviewed electronic</option>
|
|
|
- <option value="CALLED_PAYER">Called payer</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Determination Category</label>
|
|
|
- <select name="manualDeterminationCategory" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="COVERED">Covered</option>
|
|
|
- <option value="NOT_COVERED">Not Covered</option>
|
|
|
- <option value="INVALID">Invalid</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Determination Category Memo</label>
|
|
|
- <textarea name="manualDeterminationCategoryMemo" class="form-control input-sm"></textarea>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Detail Json</label>
|
|
|
- <textarea name="manualDetailJson" class="form-control input-sm"></textarea>
|
|
|
- </div>
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Is Mcd Number Valid</label>
|
|
|
- <select name="manualIsMcdNumberValid" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="YES">Yes</option>
|
|
|
- <option value="NO">No</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </div>
|
|
|
-
|
|
|
- <div class="form-group">
|
|
|
- <label for="" class="control-label">Manual Is Mcd Response Mco Active</label>
|
|
|
- <select name="manualIsMcdResponseMcoActive" class="form-control input-sm">
|
|
|
- <option value="">--select--</option>
|
|
|
- <option value="YES">Yes</option>
|
|
|
- <option value="NO">No</option>
|
|
|
- <option value="UNKNOWN">Unknown</option>
|
|
|
- </select>
|
|
|
- </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>
|
|
|
- </div>
|
|
|
- </form>
|
|
|
- </div>
|
|
|
- </div>
|
|
|
</div>
|
|
|
|
|
|
<table class="table table-sm table-bordered mt-3 mb-0">
|
|
|
- <thead>
|
|
|
- <tr>
|
|
|
- <th></th>
|
|
|
- <th>Creation Strategy</th>
|
|
|
- <th>Auto Refresh Of Client Primary Coverage Id</th>
|
|
|
- <th>Manual Determination Of Client Primary Coverage Id</th>
|
|
|
- <th>Plan Type</th>
|
|
|
- <th>Is Partbprimary</th>
|
|
|
- <th>Is Manually Determined</th>
|
|
|
- <th>Is Entry Error</th>
|
|
|
- <th>Subscriber Name First</th>
|
|
|
- <th>Subscriber Name Last</th>
|
|
|
- <th>Subscriber Sex</th>
|
|
|
- <th>Subscriber Dob</th>
|
|
|
- <th>Payer Member Identifier</th>
|
|
|
- <th>Payer Name</th>
|
|
|
- <th>Date Of Service</th>
|
|
|
- <th>Auto Is Payer Member Identifier Valid</th>
|
|
|
- <th>Auto Detail Json</th>
|
|
|
- <th>Auto Medicare Is Partbprimary</th>
|
|
|
- <th>Auto Medicare Is Partbactive</th>
|
|
|
- <th>Auto Medicare Is Partcactive</th>
|
|
|
- <th>Auto Medicare Is Inpatient</th>
|
|
|
- <th>Auto Medicare Is Hospice Or Home Health</th>
|
|
|
- <th>Auto Medicare Is Msp</th>
|
|
|
- <th>Auto Medicare Msp Memo</th>
|
|
|
- <th>Auto Medicare Mpb Start Date</th>
|
|
|
- <th>Auto Medicare Mpb End Date</th>
|
|
|
- <th>Auto Medicare Mpb Deductible</th>
|
|
|
- <th>Auto Medicare Mpb Remaining</th>
|
|
|
- <th>Auto Medicare Mpb Insurance Type</th>
|
|
|
- <th>Auto Medicare Mpb Insurance Type Label</th>
|
|
|
- <th>Auto Medicare Mpb Coinsurance Percent</th>
|
|
|
- <th>Auto Medicare Mpb Info Valid Until</th>
|
|
|
- <th>Auto Medicare Mpb Info Valid Till</th>
|
|
|
- <th>Auto Medicare Mpb Last Refreshed At</th>
|
|
|
- <th>Was Successful</th>
|
|
|
- <th>Reject Reason Code</th>
|
|
|
- <th>Reject Reason Description</th>
|
|
|
- <th>Follow Up Action Code</th>
|
|
|
- <th>Follow Up Action Description</th>
|
|
|
- <th>Details</th>
|
|
|
- <th>Is Mcn Valid Number</th>
|
|
|
- <th>Address Street Line1</th>
|
|
|
- <th>Address Street Line2</th>
|
|
|
- <th>Address City</th>
|
|
|
- <th>Address State</th>
|
|
|
- <th>Address Zip</th>
|
|
|
- <th>Is Hospice</th>
|
|
|
- <th>Mcn Response Detail</th>
|
|
|
- <th>Billing Address</th>
|
|
|
- <th>Reason Not Partb</th>
|
|
|
- <th>Reason Not Partbmemo</th>
|
|
|
- <th>Is Medicare Advantage</th>
|
|
|
- <th>Medicare Advantage Plan</th>
|
|
|
- <th>Mpb Active</th>
|
|
|
- <th>Mpb Start Date</th>
|
|
|
- <th>Mpb End Date</th>
|
|
|
- <th>Mpb Deductible</th>
|
|
|
- <th>Mpb Remaining</th>
|
|
|
- <th>Mpb Insurance Type</th>
|
|
|
- <th>Mpb Insurance Type Label</th>
|
|
|
- <th>Mpb Coinsurance Percent</th>
|
|
|
- <th>Mpb Info Valid Until</th>
|
|
|
- <th>Mpb Info Valid Till</th>
|
|
|
- <th>Mpb Last Refreshed At</th>
|
|
|
- <th>Manual Determination Strategy</th>
|
|
|
- <th>Manual Determination Category</th>
|
|
|
- <th>Manual Determination Category Memo</th>
|
|
|
- <th>Manual Detail Json</th>
|
|
|
- <th>Manual Medicare Is Partbprimary</th>
|
|
|
- <th>Manual Medicare Is Partbactive</th>
|
|
|
- <th>Manual Medicare Is Partcactive</th>
|
|
|
- <th>Manual Medicare Is Inpatient</th>
|
|
|
- <th>Manual Medicare Is Hospice Or Home Health</th>
|
|
|
- <th>Manual Medicare Is Msp</th>
|
|
|
- <th>Manual Medicare Msp Memo</th>
|
|
|
- <th>Manual Medicare Mpb Start Date</th>
|
|
|
- <th>Manual Medicare Mpb End Date</th>
|
|
|
- <th>Manual Medicare Mpb Deductible</th>
|
|
|
- <th>Manual Medicare Mpb Remaining</th>
|
|
|
- <th>Manual Medicare Mpb Insurance Type</th>
|
|
|
- <th>Manual Medicare Mpb Insurance Type Label</th>
|
|
|
- <th>Manual Medicare Mpb Coinsurance Percent</th>
|
|
|
- <th>Manual Medicare Mpb Info Valid Until</th>
|
|
|
- <th>Manual Medicare Mpb Info Valid Till</th>
|
|
|
- <th>Manual Medicare Mpb Last Refreshed At</th>
|
|
|
- <th>Auto Medicare Result Id</th>
|
|
|
- </tr>
|
|
|
- </thead>
|
|
|
+
|
|
|
<tbody>
|
|
|
@foreach($patient->primaryCoverages as $cpc)
|
|
|
<tr>
|
|
|
@@ -829,7 +273,7 @@
|
|
|
</div>
|
|
|
</form>
|
|
|
</div>
|
|
|
-
|
|
|
+ <hr/>
|
|
|
<div moe relative large>
|
|
|
<a href="" start show class="">Manual Determination</a>
|
|
|
|
|
|
@@ -982,6 +426,7 @@
|
|
|
</div>
|
|
|
</form>
|
|
|
</div>
|
|
|
+ <hr/>
|
|
|
<div moe relative large>
|
|
|
<a href="" start show class="">Manual Determination</a>
|
|
|
|
|
|
@@ -1037,6 +482,7 @@
|
|
|
</div>
|
|
|
</form>
|
|
|
</div>
|
|
|
+ <hr/>
|
|
|
<div moe relative large>
|
|
|
<a href="" start show class="">Manual Determination</a>
|
|
|
|
|
|
@@ -1092,6 +538,7 @@
|
|
|
</div>
|
|
|
</form>
|
|
|
</div>
|
|
|
+ <hr/>
|
|
|
<div moe relative large>
|
|
|
<a href="" start show class="">Manual Determination</a>
|
|
|
<form url="/api/clientPrimaryCoverage/manualDeterminationForMcrAdv" class="mcp-theme-1">
|
|
|
@@ -1185,6 +632,7 @@
|
|
|
</div>
|
|
|
</form>
|
|
|
</div>
|
|
|
+ <hr/>
|
|
|
<div moe relative large>
|
|
|
<a href="" start show class="">Manual Determination</a>
|
|
|
<form url="/api/clientPrimaryCoverage/manualDeterminationForMcdMco" class="mcp-theme-1">
|
|
|
@@ -1244,91 +692,103 @@
|
|
|
</div>
|
|
|
@endif
|
|
|
</td>
|
|
|
- <td>{{$cpc->creation_strategy}}</td>
|
|
|
- <td>{{$cpc->auto_refresh_of_client_primary_coverage_id}}</td>
|
|
|
- <td>{{$cpc->manual_determination_of_client_primary_coverage_id}}</td>
|
|
|
- <td>{{$cpc->plan_type}}</td>
|
|
|
- <td>{{$cpc->is_partbprimary}}</td>
|
|
|
- <td>{{$cpc->is_manually_determined}}</td>
|
|
|
- <td>{{$cpc->is_entry_error}}</td>
|
|
|
- <td>{{$cpc->subscriber_name_first}}</td>
|
|
|
- <td>{{$cpc->subscriber_name_last}}</td>
|
|
|
- <td>{{$cpc->subscriber_sex}}</td>
|
|
|
- <td>{{$cpc->subscriber_dob}}</td>
|
|
|
- <td>{{$cpc->payer_member_identifier}}</td>
|
|
|
- <td>{{$cpc->payer_name}}</td>
|
|
|
- <td>{{$cpc->date_of_service}}</td>
|
|
|
- <td>{{$cpc->auto_is_payer_member_identifier_valid}}</td>
|
|
|
- <td>{{$cpc->auto_detail_json}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_is_partbprimary}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_is_partbactive}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_is_partcactive}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_is_inpatient}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_is_hospice_or_home_health}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_is_msp}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_msp_memo}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_start_date}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_end_date}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_deductible}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_remaining}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_insurance_type}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_insurance_type_label}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_coinsurance_percent}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_info_valid_until}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_info_valid_till}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_mpb_last_refreshed_at}}</td>
|
|
|
- <td>{{$cpc->was_successful}}</td>
|
|
|
- <td>{{$cpc->reject_reason_code}}</td>
|
|
|
- <td>{{$cpc->reject_reason_description}}</td>
|
|
|
- <td>{{$cpc->follow_up_action_code}}</td>
|
|
|
- <td>{{$cpc->follow_up_action_description}}</td>
|
|
|
- <td>{{$cpc->details}}</td>
|
|
|
- <td>{{$cpc->is_mcn_valid_number}}</td>
|
|
|
- <td>{{$cpc->address_street_line1}}</td>
|
|
|
- <td>{{$cpc->address_street_line2}}</td>
|
|
|
- <td>{{$cpc->address_city}}</td>
|
|
|
- <td>{{$cpc->address_state}}</td>
|
|
|
- <td>{{$cpc->address_zip}}</td>
|
|
|
- <td>{{$cpc->is_hospice}}</td>
|
|
|
- <td>{{$cpc->mcn_response_detail}}</td>
|
|
|
- <td>{{$cpc->billing_address}}</td>
|
|
|
- <td>{{$cpc->reason_not_partb}}</td>
|
|
|
- <td>{{$cpc->reason_not_partbmemo}}</td>
|
|
|
- <td>{{$cpc->is_medicare_advantage}}</td>
|
|
|
- <td>{{$cpc->medicare_advantage_plan}}</td>
|
|
|
- <td>{{$cpc->mpb_active}}</td>
|
|
|
- <td>{{$cpc->mpb_start_date}}</td>
|
|
|
- <td>{{$cpc->mpb_end_date}}</td>
|
|
|
- <td>{{$cpc->mpb_deductible}}</td>
|
|
|
- <td>{{$cpc->mpb_remaining}}</td>
|
|
|
- <td>{{$cpc->mpb_insurance_type}}</td>
|
|
|
- <td>{{$cpc->mpb_insurance_type_label}}</td>
|
|
|
- <td>{{$cpc->mpb_coinsurance_percent}}</td>
|
|
|
- <td>{{$cpc->mpb_info_valid_until}}</td>
|
|
|
- <td>{{$cpc->mpb_info_valid_till}}</td>
|
|
|
- <td>{{$cpc->mpb_last_refreshed_at}}</td>
|
|
|
- <td>{{$cpc->manual_determination_strategy}}</td>
|
|
|
- <td>{{$cpc->manual_determination_category}}</td>
|
|
|
- <td>{{$cpc->manual_determination_category_memo}}</td>
|
|
|
- <td>{{$cpc->manual_detail_json}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_is_partbprimary}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_is_partbactive}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_is_partcactive}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_is_inpatient}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_is_hospice_or_home_health}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_is_msp}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_msp_memo}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_start_date}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_end_date}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_deductible}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_remaining}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_insurance_type}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_insurance_type_label}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_coinsurance_percent}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_info_valid_until}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_info_valid_till}}</td>
|
|
|
- <td>{{$cpc->manual_medicare_mpb_last_refreshed_at}}</td>
|
|
|
- <td>{{$cpc->auto_medicare_result_id}}</td>
|
|
|
+ <td>
|
|
|
+ <table class="table table-sm table-bordered table-condensed">
|
|
|
+ <tr><td>creation_strategy</td><td>{{$cpc->creation_strategy}}</td></tr>
|
|
|
+ <tr><td>auto_refresh_of_client_primary_coverage_id</td><td>{{$cpc->auto_refresh_of_client_primary_coverage_id}}</td></tr>
|
|
|
+ <tr><td>manual_determination_of_client_primary_coverage_id</td><td>{{$cpc->manual_determination_of_client_primary_coverage_id}}</td></tr>
|
|
|
+ <tr><td>plan_type</td><td>{{$cpc->plan_type}}</td></tr>
|
|
|
+ <tr><td>is_partbprimary</td><td>{{$cpc->is_partbprimary}}</td></tr>
|
|
|
+ <tr><td>is_manually_determined</td><td>{{$cpc->is_manually_determined}}</td></tr>
|
|
|
+ <tr><td>is_entry_error</td><td>{{$cpc->is_entry_error}}</td></tr>
|
|
|
+ <tr><td>subscriber_name_first</td><td>{{$cpc->subscriber_name_first}}</td></tr>
|
|
|
+ <tr><td>subscriber_name_last</td><td>{{$cpc->subscriber_name_last}}</td></tr>
|
|
|
+ <tr><td>subscriber_sex</td><td>{{$cpc->subscriber_sex}}</td></tr>
|
|
|
+ <tr><td>subscriber_dob</td><td>{{$cpc->subscriber_dob}}</td></tr>
|
|
|
+ <tr><td>payer_member_identifier</td><td>{{$cpc->payer_member_identifier}}</td></tr>
|
|
|
+ <tr><td>payer_name</td><td>{{$cpc->payer_name}}</td></tr>
|
|
|
+ <tr><td>date_of_service</td><td>{{$cpc->date_of_service}}</td></tr>
|
|
|
+ </table>
|
|
|
+ </td>
|
|
|
+ <td>
|
|
|
+ <table class="table table-sm table-bordered table-condensed">
|
|
|
+ <tr><td>auto_is_payer_member_identifier_valid</td><td>{{$cpc->auto_is_payer_member_identifier_valid}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_is_partbprimary</td><td>{{$cpc->auto_medicare_is_partbprimary}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_is_partbactive</td><td>{{$cpc->auto_medicare_is_partbactive}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_is_partcactive</td><td>{{$cpc->auto_medicare_is_partcactive}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_is_inpatient</td><td>{{$cpc->auto_medicare_is_inpatient}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_is_hospice_or_home_health</td><td>{{$cpc->auto_medicare_is_hospice_or_home_health}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_is_msp</td><td>{{$cpc->auto_medicare_is_msp}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_msp_memo</td><td>{{$cpc->auto_medicare_msp_memo}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_start_date</td><td>{{$cpc->auto_medicare_mpb_start_date}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_end_date</td><td>{{$cpc->auto_medicare_mpb_end_date}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_deductible</td><td>{{$cpc->auto_medicare_mpb_deductible}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_remaining</td><td>{{$cpc->auto_medicare_mpb_remaining}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_insurance_type</td><td>{{$cpc->auto_medicare_mpb_insurance_type}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_insurance_type_label</td><td>{{$cpc->auto_medicare_mpb_insurance_type_label}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_coinsurance_percent</td><td>{{$cpc->auto_medicare_mpb_coinsurance_percent}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_info_valid_until</td><td>{{$cpc->auto_medicare_mpb_info_valid_until}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_info_valid_till</td><td>{{$cpc->auto_medicare_mpb_info_valid_till}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_mpb_last_refreshed_at</td><td>{{$cpc->auto_medicare_mpb_last_refreshed_at}}</td></tr>
|
|
|
+ <tr><td>was_successful</td><td>{{$cpc->was_successful}}</td></tr>
|
|
|
+ <tr><td>reject_reason_code</td><td>{{$cpc->reject_reason_code}}</td></tr>
|
|
|
+ <tr><td>reject_reason_description</td><td>{{$cpc->reject_reason_description}}</td></tr>
|
|
|
+ <tr><td>follow_up_action_code</td><td>{{$cpc->follow_up_action_code}}</td></tr>
|
|
|
+ <tr><td>follow_up_action_description</td><td>{{$cpc->follow_up_action_description}}</td></tr>
|
|
|
+ <tr><td>details</td><td>{{$cpc->details}}</td></tr>
|
|
|
+ <tr><td>is_mcn_valid_number</td><td>{{$cpc->is_mcn_valid_number}}</td></tr>
|
|
|
+ <tr><td>address_street_line1</td><td>{{$cpc->address_street_line1}}</td></tr>
|
|
|
+ <tr><td>address_street_line2</td><td>{{$cpc->address_street_line2}}</td></tr>
|
|
|
+ <tr><td>address_city</td><td>{{$cpc->address_city}}</td></tr>
|
|
|
+ <tr><td>address_state</td><td>{{$cpc->address_state}}</td></tr>
|
|
|
+ <tr><td>address_zip</td><td>{{$cpc->address_zip}}</td></tr>
|
|
|
+ <tr><td>is_hospice</td><td>{{$cpc->is_hospice}}</td></tr>
|
|
|
+ <tr><td>mcn_response_detail</td><td>{{$cpc->mcn_response_detail}}</td></tr>
|
|
|
+ <tr><td>billing_address</td><td>{{$cpc->billing_address}}</td></tr>
|
|
|
+ <tr><td>reason_not_partb</td><td>{{$cpc->reason_not_partb}}</td></tr>
|
|
|
+ <tr><td>reason_not_partbmemo</td><td>{{$cpc->reason_not_partbmemo}}</td></tr>
|
|
|
+ <tr><td>is_medicare_advantage</td><td>{{$cpc->is_medicare_advantage}}</td></tr>
|
|
|
+ <tr><td>medicare_advantage_plan</td><td>{{$cpc->medicare_advantage_plan}}</td></tr>
|
|
|
+ <tr><td>mpb_active</td><td>{{$cpc->mpb_active}}</td></tr>
|
|
|
+ <tr><td>mpb_start_date</td><td>{{$cpc->mpb_start_date}}</td></tr>
|
|
|
+ <tr><td>mpb_end_date</td><td>{{$cpc->mpb_end_date}}</td></tr>
|
|
|
+ <tr><td>mpb_deductible</td><td>{{$cpc->mpb_deductible}}</td></tr>
|
|
|
+ <tr><td>mpb_remaining</td><td>{{$cpc->mpb_remaining}}</td></tr>
|
|
|
+ <tr><td>mpb_insurance_type</td><td>{{$cpc->mpb_insurance_type}}</td></tr>
|
|
|
+ <tr><td>mpb_insurance_type_label</td><td>{{$cpc->mpb_insurance_type_label}}</td></tr>
|
|
|
+ <tr><td>mpb_coinsurance_percent</td><td>{{$cpc->mpb_coinsurance_percent}}</td></tr>
|
|
|
+ <tr><td>mpb_info_valid_until</td><td>{{$cpc->mpb_info_valid_until}}</td></tr>
|
|
|
+ <tr><td>mpb_info_valid_till</td><td>{{$cpc->mpb_info_valid_till}}</td></tr>
|
|
|
+ <tr><td>mpb_last_refreshed_at</td><td>{{$cpc->mpb_last_refreshed_at}}</td></tr>
|
|
|
+ <tr><td>manual_determination_strategy</td><td>{{$cpc->manual_determination_strategy}}</td></tr>
|
|
|
+ <tr><td>manual_determination_category</td><td>{{$cpc->manual_determination_category}}</td></tr>
|
|
|
+ <tr><td>manual_determination_category_memo</td><td>{{$cpc->manual_determination_category_memo}}</td></tr>
|
|
|
+ <tr><td>manual_detail_json</td><td>{{$cpc->manual_detail_json}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_is_partbprimary</td><td>{{$cpc->manual_medicare_is_partbprimary}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_is_partbactive</td><td>{{$cpc->manual_medicare_is_partbactive}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_is_partcactive</td><td>{{$cpc->manual_medicare_is_partcactive}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_is_inpatient</td><td>{{$cpc->manual_medicare_is_inpatient}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_is_hospice_or_home_health</td><td>{{$cpc->manual_medicare_is_hospice_or_home_health}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_is_msp</td><td>{{$cpc->manual_medicare_is_msp}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_msp_memo</td><td>{{$cpc->manual_medicare_msp_memo}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_start_date</td><td>{{$cpc->manual_medicare_mpb_start_date}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_end_date</td><td>{{$cpc->manual_medicare_mpb_end_date}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_deductible</td><td>{{$cpc->manual_medicare_mpb_deductible}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_remaining</td><td>{{$cpc->manual_medicare_mpb_remaining}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_insurance_type</td><td>{{$cpc->manual_medicare_mpb_insurance_type}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_insurance_type_label</td><td>{{$cpc->manual_medicare_mpb_insurance_type_label}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_coinsurance_percent</td><td>{{$cpc->manual_medicare_mpb_coinsurance_percent}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_info_valid_until</td><td>{{$cpc->manual_medicare_mpb_info_valid_until}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_info_valid_till</td><td>{{$cpc->manual_medicare_mpb_info_valid_till}}</td></tr>
|
|
|
+ <tr><td>manual_medicare_mpb_last_refreshed_at</td><td>{{$cpc->manual_medicare_mpb_last_refreshed_at}}</td></tr>
|
|
|
+ <tr><td>auto_medicare_result_id</td><td>{{$cpc->auto_medicare_result_id}}</td></tr>
|
|
|
+ </table>
|
|
|
+ </td>
|
|
|
+ <td>
|
|
|
+ <table>
|
|
|
+ <tr><td>auto_detail_json</td><td><pre>{{$cpc->auto_detail_json}}</pre></td></tr>
|
|
|
+ </table>
|
|
|
+ </td>
|
|
|
</tr>
|
|
|
@endforeach
|
|
|
</tbody>
|
=