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
| P | R | E | S | C | R | I | B | E | R | - | I | D | A | W | - | C | O | D | E |
| I | E | C | I | V | R | E | S | - | F | O | - | E | T | A | D | I | Y | V | V |
| I | P | G | E | N | E | R | I | C | - | N | A | M | E | O | E | I | K | Z | Q |
| R | E | J | E | C | T | I | O | N | - | C | O | D | E | W | S | J | Q | B | C |
| T | T | C | D | N | A | B | P | X | Z | Y | A | P | F | D | N | Z | U | Q | H |
| K | V | P | Y | G | E | G | A | D | Y | L | V | R | H | M | E | C | J | P | X |
| D | E | M | A | N | - | R | E | B | I | R | C | S | E | R | P | I | B | O | W |
| P | H | A | P | V | R | V | I | A | H | E | P | J | C | L | I | V | R | O | R |
| R | X | N | J | X | H | P | Y | C | G | D | M | J | W | A | D | X | A | R | S |
| O | A | U | O | G | F | X | L | Y | - | W | T | Q | I | H | - | Q | N | T | S |
| V | O | F | G | Q | H | O | V | Z | H | I | X | P | F | V | Y | Y | D | G | A |
| I | O | A | O | T | E | O | Q | Z | R | Q | N | G | P | H | T | V | - | N | L |
| D | F | C | Y | L | P | P | U | S | - | Y | A | D | Z | Y | I | G | N | I | C |
| E | V | T | A | C | J | A | L | T | E | K | P | L | I | N | T | O | A | N | - |
| R | G | U | T | B | B | V | M | Y | I | V | Q | N | J | C | N | C | M | I | A |
| - | I | R | X | - | N | U | M | B | E | R | N | B | S | B | A | A | E | A | E |
| N | A | E | O | G | U | W | V | K | O | X | E | T | T | X | U | T | C | M | D |
| A | Q | R | O | P | R | J | Y | Q | Y | G | N | M | B | U | Q | B | O | E | S |
| M | K | E | G | A | S | S | E | M | - | N | O | I | T | C | E | J | E | R | E |
| E | H | D | A | T | E | - | S | U | B | M | I | T | T | E | D | G | D | R | F |
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