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