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