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