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