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