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