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