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