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