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