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