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