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