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