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