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