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