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