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