._headRow_yxni4_6{justify-content:space-between;align-items:flex-start;gap:16px;margin-top:14px;display:flex}._title_yxni4_13{color:#000;font-size:17px;font-weight:800}._titleLarge_yxni4_18{color:#000;font-size:21px;font-weight:800}._sub_yxni4_23{color:#202638;margin-top:2px;font-size:12px}._headRight_yxni4_28{text-align:right;color:#000;flex:none;font-size:12px;line-height:1.6}._headRightStrong_yxni4_35{font-size:13px;font-weight:800}._priority_yxni4_39{color:#b3261e;font-weight:800}._rule_yxni4_44{border-top:1px solid #202638;margin:10px 0}._row_yxni4_50{color:#000;gap:14px;padding:6px 0;font-size:12.5px;line-height:1.5;display:flex}._label_yxni4_58{text-align:right;color:#202638;flex:none;width:170px;font-weight:700}._value_yxni4_65{flex:1;min-width:0}._twoCols_yxni4_69{gap:24px;display:flex}._twoCols_yxni4_69>div{flex:1;min-width:0}._colLabel_yxni4_77{color:#202638;font-weight:700}._instructions_yxni4_83{color:#202638;background:#f1f4f7;border-radius:6px;padding:8px 12px;font-style:italic}._chevronItem_yxni4_91{padding:2px 0}._patientBlock_yxni4_96{color:#000;font-size:12.5px;line-height:1.55}._nameHint_yxni4_101{color:#5b6472;font-size:10px;font-style:italic}._split_yxni4_108{color:#000;gap:0;font-size:12.5px;line-height:1.5;display:flex}._splitLeft_yxni4_115{flex:1;min-width:0;padding-right:16px}._splitRight_yxni4_120{border-left:1px solid #202638;flex:1;min-width:0;padding-left:16px}._section_yxni4_126{margin-bottom:8px}._sigBlock_yxni4_130{margin-top:16px}._attestation_yxni4_133{color:#000;margin-top:4px;font-size:12px}._npi_yxni4_138{color:#202638;margin-top:2px;font-size:11.5px}._footer_yxni4_144{color:#202638;border-top:1px solid #202638;justify-content:space-between;gap:16px;margin-top:16px;padding-top:4px;font-size:10.5px;display:flex}