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