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