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