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