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