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