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