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