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