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