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