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