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