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