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