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