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