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