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