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