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