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