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