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