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