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