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