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