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