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