Claims Detail Screen
Locate the terms found in the claims detail screen.
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BRAND-NAME
DATE-OF-SERVICE
DATE-SUBMITTED
DAW-CODE
DAY-SUPPLY
DEA-CLASS
GENERIC-INDICATOR
GENERIC-NAME
GPI
MANUFACTURER
NABP
NDC
NPI
PRESCRIBER-ID
PRESCRIBER-NAME
PROVIDER-NAME
QUANTITY-DIPENSED
REJECTION-CODE
REJECTION-MESSAGE
REMAININGTROOP
RX-NUMBER
| O | N | Z | T | R | R | B | M | X | Z | L | T | I | M | S | M | S | A | R | N |
| U | C | P | R | E | J | E | C | T | I | O | N | - | C | O | D | E | W | M | Q |
| H | G | R | E | M | A | I | N | I | N | G | T | R | O | O | P | S | O | T | G |
| H | B | E | O | D | A | W | - | C | O | D | E | U | N | X | C | S | W | N | J |
| H | V | J | A | T | O | G | M | B | R | A | N | D | - | N | A | M | E | O | W |
| Y | D | E | Q | U | A | N | T | I | T | Y | - | D | I | P | E | N | S | E | D |
| P | A | C | J | P | G | C | R | F | S | Z | A | P | E | R | T | K | M | M | A |
| R | T | T | H | B | J | L | I | T | Q | Y | I | M | Q | E | N | H | E | A | T |
| E | E | I | D | I | A | C | Y | D | - | P | A | G | I | S | I | B | L | N | E |
| S | - | O | T | E | A | Z | A | S | N | N | X | O | Z | C | V | T | M | - | - |
| C | S | N | G | I | K | O | U | S | - | I | K | F | T | R | Q | B | B | R | O |
| R | U | - | O | Y | V | P | S | C | W | K | - | J | W | I | X | M | E | E | F |
| I | B | M | N | G | P | A | I | C | D | R | S | C | I | B | I | A | P | D | - |
| B | M | E | C | L | L | R | Y | T | U | S | I | J | I | E | I | T | G | I | S |
| E | I | S | Y | C | E | R | E | B | M | U | N | - | X | R | Z | C | M | V | E |
| R | T | S | - | N | G | W | J | M | U | F | E | X | N | - | E | D | L | O | R |
| - | T | A | E | L | H | H | B | K | X | G | J | R | O | N | L | N | I | R | V |
| I | E | G | P | I | L | Y | O | T | U | X | T | L | C | A | C | A | E | P | I |
| D | D | E | R | E | R | U | T | C | A | F | U | N | A | M | H | B | A | G | C |
| F | H | G | T | K | I | Q | R | X | D | T | P | V | O | E | Y | P | W | P | E |
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