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