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