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