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