.GenericMessage-module__RBcN-W__standardVerticalMargin{margin:1rem 0}.GenericMessage-module__RBcN-W__standardMargin{margin:1rem}.GenericMessage-module__RBcN-W__inlineBlock{border-radius:.5rem;align-items:center;padding:1rem;display:inline-flex;box-shadow:0 2px 4px #0000001a}.GenericMessage-module__RBcN-W__icon{align-items:center;margin-right:1rem;display:flex}.GenericMessage-module__RBcN-W__mainContent{flex:1}.GenericMessage-module__RBcN-W__mainContent h2{margin:0 0 .5rem;font-size:1.2rem;font-weight:700}.GenericMessage-module__RBcN-W__mainContent p{margin:0;line-height:1.4}.GenericMessage-module__RBcN-W__success{color:#155724;background-color:#d4edda;border:1px solid #c3e6cb}.GenericMessage-module__RBcN-W__error{color:#721c24;background-color:#f8d7da;border:1px solid #f5c6cb}.GenericMessage-module__RBcN-W__notify{color:#0c5460;background-color:#d1ecf1;border:1px solid #bee5eb}.GenericMessage-module__RBcN-W__warning{color:#856404;background-color:#fff3cd;border:1px solid #ffeaa7}
button:disabled.PrimaryButton-module__PuI0Ia__buttonGeneric,button[disabled].PrimaryButton-module__PuI0Ia__buttonGeneric{color:#fff;background-color:#ddd;border:2px solid #0000}.PrimaryButton-module__PuI0Ia__buttonGeneric{color:#00a0df;background-color:#fff;border:2px solid #00a0df;border-radius:.4em;padding:.5rem .75rem;font-size:16px;font-weight:700;transition-duration:.3s}.PrimaryButton-module__PuI0Ia__buttonGeneric:not(:disabled):hover{transform:translateY(-10%);box-shadow:0 0 12px #1c558940}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__blue:not(:disabled):hover{color:#fff;cursor:pointer;background-color:#00a0df}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__anchor:not(:disabled):hover{box-shadow:none}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__blue{color:#fff;background-color:#00a0df;border:2px solid #0000}.PrimaryButton-module__PuI0Ia__buttonGeneric:not(:disabled).PrimaryButton-module__PuI0Ia__blue:hover{background-color:#0089bf}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__orange{color:#fff;background-color:#ed8d41;border:2px solid #0000}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__orange:not(:disabled):hover{background-color:#ee7515}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__cancel{color:#fff;border:2px so;background-color:#0073e6}.PrimaryButton-module__PuI0Ia__buttonGeneric.PrimaryButton-module__PuI0Ia__negative{color:#000;background-color:#eee;border:2px solid #0000}.PrimaryButton-module__PuI0Ia__closeButton{border-radius:.4rem;transition-duration:.3s}.PrimaryButton-module__PuI0Ia__closeButton:hover{color:#fff;-webkit-user-select:none;user-select:none;background:red;border-radius:.4rem}.PrimaryButton-module__PuI0Ia__anchor{color:#04a1de;border-radius:none;cursor:pointer;transition-duration:none;background-color:#0000;border:none;padding:0;font-size:14px;font-weight:700;text-decoration:underline}.PrimaryButton-module__PuI0Ia__anchor:hover{-webkit-user-select:none;user-select:none;background:0 0}.PrimaryButton-module__PuI0Ia__marginLeft{margin-top:2rem;margin-left:auto;margin-right:0;display:block}.PrimaryButton-module__PuI0Ia__clickableElement{cursor:pointer}@media screen and (max-width:600px){button.PrimaryButton-module__PuI0Ia__buttonGeneric{font-size:3.5vw}}
.FileUpload-module__laOQEq__standardTopMargin{margin-top:2rem}.FileUpload-module__laOQEq__supportingDocuments{margin-bottom:2rem}.FileUpload-module__laOQEq__bold{font-weight:700}.FileUpload-module__laOQEq__documentGrid{grid-template-columns:3% 45% 52%;align-items:center;column-gap:1rem;padding:.5rem .5rem .5rem 0;display:grid}.FileUpload-module__laOQEq__documentGrid.FileUpload-module__laOQEq__failedSubmission{background-color:#fff1f1}.FileUpload-module__laOQEq__removeDocument{background-color:#0000;border:none;height:fit-content;padding:0;font-size:1.5em;line-height:1}.FileUpload-module__laOQEq__removeDocument:hover{cursor:pointer}.FileUpload-module__laOQEq__deleteIcon{color:red;font-size:18px}.FileUpload-module__laOQEq__documentTypeSelect{box-sizing:border-box;border:1px solid #c9d1d9;height:2.25rem;margin:0 .5rem;font-size:16px;line-height:2.25rem}.FileUpload-module__laOQEq__errorWrapper{flex-direction:column;grid-area:3/2/4/4;margin:1rem 0 0 .5rem;display:flex}.FileUpload-module__laOQEq__documentInfo{word-wrap:break-word;display:contents}.FileUpload-module__laOQEq__fileName{grid-area:2/2/3/4;width:93%;margin-bottom:0;padding-left:.5rem}.FileUpload-module__laOQEq__fileSize{grid-area:1/3/2/4;margin:0}.FileUpload-module__laOQEq__flexRow{flex-direction:row;display:flex}.FileUpload-module__laOQEq__addDocument{width:fit-content;margin-top:1rem}.FileUpload-module__laOQEq__addDocumentButton{cursor:pointer;-webkit-user-select:none;user-select:none;background-color:#0000;border:none;align-items:center;display:flex}.FileUpload-module__laOQEq__addDocumentButton:hover{cursor:pointer}.FileUpload-module__laOQEq__addDocumentPlus{color:#fff;background-color:#00a0df;border-radius:50%;padding:.05rem .4rem;font-size:20px}.FileUpload-module__laOQEq__addDocumentText{color:#00a0df;margin-left:.4rem;font-size:16px;text-decoration:underline}.FileUpload-module__laOQEq__addDocumentText:hover{text-decoration:none}.FileUpload-module__laOQEq__italic{font-style:italic}
.BackConfirmation-module__fCrrfa__overlay{z-index:1000;background:#00000080;justify-content:center;align-items:center;width:100%;height:100%;display:flex;position:fixed;top:0;left:0}.BackConfirmation-module__fCrrfa__modal{background:#fff;border-radius:8px;width:fit-content;max-width:500px;max-height:90vh;overflow:auto;box-shadow:0 4px 20px #00000026}.BackConfirmation-module__fCrrfa__modalContent{padding:2rem}.BackConfirmation-module__fCrrfa__modalTitle{color:#333;margin:0 0 1rem;font-size:1.5rem}.BackConfirmation-module__fCrrfa__modalMessage{color:#666;margin:0 0 2rem;line-height:1.5}.BackConfirmation-module__fCrrfa__modalActions{justify-content:space-between;gap:1rem;display:flex}@media screen and (max-width:600px){.BackConfirmation-module__fCrrfa__modal{width:fit-content}.BackConfirmation-module__fCrrfa__modalContent{padding:1.5rem}.BackConfirmation-module__fCrrfa__modalActions{flex-direction:column;gap:.5rem}}
.DocumentRequest-module__7hJ70W__noMargin{margin:0}.DocumentRequest-module__7hJ70W__emailForm{flex-direction:column;row-gap:.5rem;max-width:60%;margin:2rem 0;display:flex}.DocumentRequest-module__7hJ70W__emailForm .DocumentRequest-module__7hJ70W__error{margin-top:.5rem}.DocumentRequest-module__7hJ70W__emailForm input{width:60%;padding:.25rem;font-size:16px}.DocumentRequest-module__7hJ70W__reasonCodes h4{color:#000}.DocumentRequest-module__7hJ70W__reasonCodes p{color:#000;align-items:center;gap:8px;margin:0;display:flex}.DocumentRequest-module__7hJ70W__reasonCodes .DocumentRequest-module__7hJ70W__material-icons{font-feature-settings:"liga";letter-spacing:normal;-moz-osx-font-smoothing:grayscale;text-rendering:optimizeLegibility;text-transform:none;-webkit-user-select:none;user-select:none;-webkit-font-smoothing:antialiased;white-space:nowrap;word-wrap:normal;direction:ltr;font-family:Material Icons;font-style:normal;font-weight:400;line-height:1;display:inline-block}.DocumentRequest-module__7hJ70W__backAndSubmit{flex-direction:row;column-gap:1rem;margin-top:2rem;display:flex}.DocumentRequest-module__7hJ70W__submitMessage{width:fit-content;margin:2rem 0}@media screen and (max-width:600px){.DocumentRequest-module__7hJ70W__emailForm{max-width:100%}.DocumentRequest-module__7hJ70W__emailForm input{width:80%}}
.InitialVerification-module__Do7d_W__additionalFieldsForNoDcn{row-gap:.5rem;max-width:50%;margin-left:2rem}.InitialVerification-module__Do7d_W__infoModal{z-index:1000;background-color:#fff;border:1px solid #ddd;border-radius:4px;position:absolute;box-shadow:0 0 12px #1c558940}.InitialVerification-module__Do7d_W__infoModal>p{margin:0}.InitialVerification-module__Do7d_W__infoModalDcn{width:14rem;padding:.5rem;top:0;left:calc(100% + 5rem)}.InitialVerification-module__Do7d_W__infoModalSubId{width:18rem;max-width:300px;padding:.5rem;top:-2rem;left:calc(100% + 1rem)}.InitialVerification-module__Do7d_W__infoModalSubId>img{width:100%}.InitialVerification-module__Do7d_W__initialVerification form{row-gap:1.5rem;margin:2rem 0}.InitialVerification-module__Do7d_W__initialVerification form button{width:fit-content}.InitialVerification-module__Do7d_W__infoIcon{cursor:pointer;background-color:#1c5589;border:none;border-radius:50%;width:20px;height:20px;position:relative}.InitialVerification-module__Do7d_W__infoIcon:before{color:#fff;content:"i";font-family:serif;font-size:12px;font-style:italic;font-weight:700;position:absolute;top:50%;left:50%;transform:translate(-50%,-50%)}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__dcnField{width:fit-content}.InitialVerification-module__Do7d_W__initialVerification form input{margin:.5rem 0}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__dateOfServiceField .InitialVerification-module__Do7d_W__error{margin:.5rem 0 0}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__dcnField input{width:10rem}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__dcnField .InitialVerification-module__Do7d_W__error{margin:.5rem 0 1rem}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__labelAndIcon{column-gap:.25rem}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__performingNpiField .InitialVerification-module__Do7d_W__error{margin:.5rem 0 1rem}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__prefixAndSubId{column-gap:1rem;width:fit-content}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__prefixAndSubIdWrapper{row-gap:.5rem}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__prefixField input{width:4rem;margin-top:calc(.5rem + 1px)}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__subIdField{max-width:75%;position:relative}@media screen and (max-width:1200px){.InitialVerification-module__Do7d_W__infoModalDcn{padding:1rem;position:fixed;top:30%;left:50%;transform:translate(-50%)}.InitialVerification-module__Do7d_W__infoModalSubId{padding:1rem;position:fixed;top:30%;left:50%;transform:translate(-50%);box-shadow:0 0 12px #1c558940}}@media screen and (max-width:600px){.InitialVerification-module__Do7d_W__additionalFieldsForNoDcn{max-width:75%}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__prefixAndSubId{flex-direction:column;row-gap:1rem}.InitialVerification-module__Do7d_W__initialVerification form .InitialVerification-module__Do7d_W__sub-id-and-dcn{flex-direction:column;gap:1rem 0}}
.RequestSelection-module__vJhY2W__requestSelection{margin:2rem 0}.RequestSelection-module__vJhY2W__claimsTable{border-collapse:collapse;width:100%;margin-top:1rem}.RequestSelection-module__vJhY2W__claimsTable td,.RequestSelection-module__vJhY2W__claimsTable th{text-align:left;border-bottom:1px solid #ddd;padding:.5rem 1.5rem}.RequestSelection-module__vJhY2W__claimsTable th{background-color:#f5f5f5;border-bottom:2px solid #d0d0d0;font-weight:700}.RequestSelection-module__vJhY2W__claimsTable tr:nth-child(2n){background-color:#efefef}.RequestSelection-module__vJhY2W__claimsTable tr:hover{background-color:#e8f4f8}.RequestSelection-module__vJhY2W__claimsTable td:last-child{text-align:center}@media screen and (max-width:500px){.RequestSelection-module__vJhY2W__claimsTable td,.RequestSelection-module__vJhY2W__claimsTable th{padding:1vw;font-size:3.5vw}.RequestSelection-module__vJhY2W__claimsTable{font-size:14px}}
.PatientVerification-module__3VoxOa__additionalFieldsForNoDcn{row-gap:.5rem;max-width:30%;margin-left:2rem}.PatientVerification-module__3VoxOa__patientVerification form{row-gap:1.5rem;margin:2rem 0}.PatientVerification-module__3VoxOa__patientVerification form button,.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__dcnField{width:fit-content}.PatientVerification-module__3VoxOa__patientVerification form input{margin:.5rem 0}.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__dcnField input{width:10rem}.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__labelAndIcon{column-gap:.25rem}.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__prefixField input{width:3rem}.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__subIdField{max-width:75%}.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__subIdAndDcn{column-gap:1rem}@media screen and (max-width:600px){.PatientVerification-module__3VoxOa__patientVerification form .PatientVerification-module__3VoxOa__subIdAndDcn{flex-direction:column;gap:1rem 0}}