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