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