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