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