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