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