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