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