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