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