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