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