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