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