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