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