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