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