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