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