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