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