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@@ -188,7 +188,7 @@
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<tr>
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<td class="p-0">
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<input icd-autocomplete-code type="text" class="rounded-0 border-0 shadow-none icd-input width-70px pr-0 min-width-unset"
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- name="reasonIcd2" placeholder="ICD 1" value="{{@$note->note_reason_icd2}}" autocomplete="off">
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+ name="reasonIcd2" placeholder="ICD 2" value="{{@$note->note_reason_icd2}}" autocomplete="off">
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</td>
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<td class="p-0">
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<input icd-autocomplete-description type="text" class="rounded-0 border-0 shadow-none form-control form-control-sm min-width-unset"
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@@ -199,7 +199,7 @@
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<tr>
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<td class="p-0">
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<input icd-autocomplete-code type="text" class="rounded-0 border-0 shadow-none icd-input width-70px pr-0 min-width-unset"
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- name="reasonIcd3" placeholder="ICD 1" value="{{@$note->note_reason_icd3}}" autocomplete="off">
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+ name="reasonIcd3" placeholder="ICD 3" value="{{@$note->note_reason_icd3}}" autocomplete="off">
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</td>
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<td class="p-0">
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<input icd-autocomplete-description type="text" class="rounded-0 border-0 shadow-none form-control form-control-sm min-width-unset"
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@@ -210,7 +210,7 @@
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<tr>
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<td class="p-0">
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<input icd-autocomplete-code type="text" class="rounded-0 border-0 shadow-none icd-input width-70px pr-0 min-width-unset"
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- name="reasonIcd4" placeholder="ICD 1" value="{{@$note->note_reason_icd4}}" autocomplete="off">
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+ name="reasonIcd4" placeholder="ICD 4" value="{{@$note->note_reason_icd4}}" autocomplete="off">
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</td>
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<td class="p-0">
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<input icd-autocomplete-description type="text" class="rounded-0 border-0 shadow-none form-control form-control-sm min-width-unset"
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