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