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