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