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