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