._formRow_bul0f_1{margin-block:4px}._reservedForNuccField_bul0f_5{height:44px}._section_bul0f_9{background-color:var(--mod-coverage-details-bg-color,#fafafa);border-radius:6px;margin-bottom:1rem;padding:.5rem}._title_16l21_1{color:var(--text-color-help,#6c757d);white-space:nowrap;text-overflow:ellipsis;padding-bottom:5px;overflow:hidden}._title_16l21_1 ._asterisk_16l21_8{color:var(--primary-color);font-size:var(--font-size);margin-inline-start:4px;font-family:SimSun,sans-serif;line-height:1}._section_ijp9x_1{background-color:var(--mod-coverage-details-bg-color,#fafafa);border-radius:6px;margin-bottom:1rem;padding:.5rem}._physicianOrSupplierDivider_ijp9x_8{margin-top:1rem}._fullWidth_ijp9x_12{width:100%}._reservedForNuccField_ijp9x_16{height:44px}._error_ijp9x_20{color:var(--error-color,#ff4d4f);padding-bottom:5px;position:absolute;top:5px;right:1rem}._formRow_ijp9x_28{margin-block:8px}._emptyField_ijp9x_32{height:58px}._section_4y0d8_1{background-color:var(--mod-coverage-details-bg-color,#fafafa);border-radius:6px;margin-bottom:1rem;padding:.5rem}._fullWidth_4y0d8_8{width:100%}._provider_4y0d8_12 ._input_4y0d8_12 .ant-input{height:35px;font-size:12px;line-height:35px}._provider_4y0d8_12 ._npi_4y0d8_17,._provider_4y0d8_12 ._otherId_4y0d8_18{flex-direction:row;display:flex}._provider_4y0d8_12 ._npi_4y0d8_17{margin-top:4px}._provider_4y0d8_12 ._npi_4y0d8_17 ._field_4y0d8_25{width:100%}._provider_4y0d8_12 ._title_4y0d8_28{color:var(--text-color-help,#6c757d);align-items:center;margin-right:.5rem;display:flex}._section_kqbqi_1{background-color:var(--mod-coverage-details-bg-color,#fafafa);border-radius:6px;margin-bottom:1rem;padding:.5rem}._fullWidth_kqbqi_8{width:100%}._diagnosis_kqbqi_12 ._icd_kqbqi_12{margin-left:auto}._diagnosis_kqbqi_12 ._icd_kqbqi_12 .ant-select{height:35px;line-height:35px}._diagnosis_kqbqi_12 ._icd_kqbqi_12 .ant-select .ant-select-selector{font-size:12px}._diagnosis_kqbqi_12 .ant-select{height:40px;line-height:40px}._diagnosis_kqbqi_12 ._list_kqbqi_26{margin-top:4px}._diagnosis_kqbqi_12 ._error_kqbqi_29{color:var(--error-color,#ff4d4f);padding-bottom:5px}._diagnose_kqbqi_34{flex-direction:row;margin-bottom:4px;display:flex}._diagnose_kqbqi_34 ._field_kqbqi_39{width:100%}._diagnose_kqbqi_34 ._pointer_kqbqi_42{color:var(--text-color-help,#6c757d);align-items:center;min-width:1rem;display:flex}._section_1u3nf_1{background-color:var(--mod-coverage-details-bg-color,#fafafa);border-radius:6px;margin-bottom:1rem;padding:.5rem}._formRow_1u3nf_8{margin-block:4px}._reservedForNuccField_1u3nf_12{height:44px}._insuranceSelect_11lqv_1,._referenceCheckbox_11lqv_5{width:100%}._selectionRow_11lqv_9{width:100%;margin-top:.5em}