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