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