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