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