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