._wrapper_h877i_1{flex-direction:column;display:flex;position:relative}._wrapper_h877i_1 ._error_h877i_6{color:var(--error-color);z-index:3;position:absolute;top:50%;right:12px;transform:translateY(-50%)}._wrapper_h877i_1._errorWide_h877i_14 ._error_h877i_6{right:2rem}._wrapper_h877i_1 ._label_h877i_17{color:var(--text-color-help,#6c757d);font-size:var(--font-size,16px);pointer-events:none;z-index:2;transition:all .2s;position:absolute;top:50%;left:12px;transform:translateY(-50%)}._wrapper_h877i_1 ._label_h877i_17 ._asterisk_h877i_28{color:var(--primary-color);font-size:var(--font-size);margin-inline-start:4px;font-family:SimSun,sans-serif;line-height:1}._wrapper_h877i_1 input:focus+._label_h877i_17,._wrapper_h877i_1 input:not(:placeholder-shown)+._label_h877i_17,._wrapper_h877i_1 textarea:focus+._label_h877i_17,._wrapper_h877i_1 textarea:not(:placeholder-shown)+._label_h877i_17,._wrapper_h877i_1 select:focus+._label_h877i_17,._wrapper_h877i_1 select:not([value=""])+._label_h877i_17,._wrapper_h877i_1 ._ant-picker-focused_h877i_41+._label_h877i_17,._wrapper_h877i_1 ._ant-picker_h877i_41 ._ant-picker-input_h877i_42>input[value]:not([value=""])+._label_h877i_17,._wrapper_h877i_1 ._active_h877i_43{background:var(--neutral-white-color,#fff);padding:0 4px;font-size:12px;top:-4px;left:8px;transform:none}._wrapper_h877i_1 ._label_h877i_17._small_h877i_51._active_h877i_43{font-size:10px}._scrollContainer_1bv76_1{width:100%;overflow-x:auto}._table_1bv76_6{border-collapse:collapse;width:100%;color:var(--text-color-help,#6c757d)}._table_1bv76_6 th,._table_1bv76_6 td{text-align:center;vertical-align:middle;border:1px solid #bbb;padding:4px;font-weight:400}._smallInput_1bv76_20{width:3rem}._familyPlan_1bv76_24{width:7rem}._divider_1bv76_28{margin-block:4px}._npi_1bv76_32{height:30px}._qualifier_1bv76_36 .ant-select{height:30px;line-height:30px}._qualifier_1bv76_36 .ant-select .ant-select-selector{font-size:12px}._providerId_1bv76_44 .ant-input{height:30px;font-size:12px;line-height:30px}._addBtn_1bv76_50{margin-top:1rem}._minWidthInput_1bv76_54{min-width:10rem}._paymentDetailsRow_1bv76_58{background-color:var(--mod-coverage-service-payment-details-bg-color,#e9f3ff)}._paymentDetailsRow_1bv76_58 td{vertical-align:top}._paymentDetailsRow_1bv76_58 td>div:first-child{margin-bottom:8px}._fullWidth_1bv76_68{width:100%}._formRow_1bv76_72{margin-block:8px}._modInline_1bv76_76{grid-template-columns:repeat(4,minmax(3rem,1fr));gap:4px;display:grid}._adjustmentList_1bv76_82{gap:8px;display:grid}._adjustmentRow_1bv76_87{grid-template-columns:repeat(4,minmax(90px,1fr)) auto;align-items:start;gap:8px;display:grid}._adjustmentDeleteBtn_1bv76_94{place-self:center}