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