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