| Prompt |
Response |
Req |
Len |
| Beginning Plan Code |
Type the code you want to start with or leave the text box blank to start with the first code in the table. |
|
5 |
| End with Plan Code |
Type the code you want to end with or leave the text box blank to end with the last code in the table. |
|
5 |
| Insurance Class |
Type the code you want to start with or leave the text box blank to start with the first code in the table. |
|
5 |
| Begin with Insurance Carrier |
Type the code you want to end with or leave the text box blank to end with the last code in the table. |
|
5 |
| End with Insurance Carrier |
Type the code you want to start with or leave the text box blank to start with the first code in the table. |
|
5 |
| Begin with Procedure Code |
Type the code you want to end with or leave the text box blank to end with the last code in the table. |
|
10 |
| End with Procedure Code |
Type the date you want the report to start with or click the calendar icon to select a date. |
|
10 |
| Print from Date |
Type the date you want the report to end with or click the calendar icon to select a date. |
|
10 |
| Print through Date |
If you only want to print a summary, select this check box. |
|
10 |
| Summary Only |
If you only want to print a summary, select this check box. |
 |
1 |