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