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