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