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