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