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