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