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