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