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