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