The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)

The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)

Appendix C - PBP_2008_screenshots_sec_b13

The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)

OMB: 0938-0763

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PBP 2008 Data Entry System Screens


Section B – 13a – Blood Services – Base 1 Screen


Section B – 13a – Blood Services – Base 2 Screen


Section B – 13b – Acupuncture – Base 1 Screen


Section B – 13b – Acupuncture – Base 2 Screen


Section B – 13b – Acupuncture – Base 3 Screen


Section B – 13c – Other 1 – Base 1 Screen


Section B – 13c – Other 1 – Base 2 Screen


Section B – 13c – Other 1 – Base 3 Screen


Section B – 13d – Other 2 – Base 1 Screen


Section B – 13d – Other 2 – Base 2 Screen


Section B – 13d – Other 2 – Base 3 Screen


Section B – 13e – Other 3 – Base 1 Screen


Section B – 13e – Other 3 – Base 2 Screen


Section B – 13e – Other 3 – Base 3 Screen


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