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