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