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