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