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