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