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