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