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