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