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