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