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