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