Prompt | Response | Req | Len |
---|---|---|---|
Referral Source Code | Type the code you want or click the magnifying glass to search the table. | ![]() |
10 |
Insurance Carrier | Type the code you want or click the magnifying glass to search the table. | ![]() |
5 |
Provider Number | Type the provider number to be used for this insurance carrier and this referral source. | ![]() |
20 |