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