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