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