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