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