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