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