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