Template Merge Fields
| Template Field Name | Description |
| CONTRACT_NUMBER | |
| PERFORMER_FIRST_NAME | |
| PERFORMER_INITIAL | |
| PERFORMER_LAST_NAME | |
| PERFORMER_TITLE | |
| PERFORMER_GDC | |
| PERFORMER_NUMBER | |
| CLAIM_SUBM_DATE | |
| CLAIM_COUNT | |
| CLAIM_REF | |
| CLAIM_FORM | |
| CLAIM_MESSAGE | |
| CLAIM_VALUE | |
| CLAIM_PATIENT_STAGE | |
| CLAIM_PATIENT | |
| CLAIMED_TOTAL | |
| TODAYS_DATE |