Prompt | Response | Req | Len |
---|---|---|---|
For Electronic Form | Select the code you want from the Electronic Form list. | 2 | |
All or Select Carriers | Select the option you want, to include either All carriers or a Select carrier from within the Electronic Form type. | 1 | |
Carrier Code | Type the code you want, click the magnifying glass to search the table or leave the field blank to include all codes in the table. | 5 | |
All or Select Doctors | Select the option you want to include claims for All Doctors or a Select Doctor. | 1 | |
Doctor Code | Type the code you want, select a code from the Doctor Code list, or leave the field blank to include all codes in the table. | 5 |