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