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