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