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