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