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