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