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