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