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