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