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