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