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