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