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