| Submitter ID | Enter your patient eligibility Submitter ID for this Payor. |
| Receiver ID | Enter the Receiver ID for this Payor. Use the drop-down menu. |
| URL | Enter the patient eligibility URL for this Payor. |
| Submitter ID | Enter your patient eligibility Submitter ID for this Payor. |
| Receiver ID | Enter the Receiver ID for this Payor. Use the drop-down menu. |
| URL | Enter the patient eligibility URL for this Payor. |
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