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