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