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