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_c_VT_Foreign

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 C – V/T – General –Base 1 Screen

Section C – V/T – General –Foreign – Base 1 Screen

Section C – V/T – General – Foreign – Base 2 Screen

Section C – V/T – General – Foreign – Base 3 Screen

Section C – V/T – General – Foreign – Notes Screen


Section C – V/T – Inpatient – Foreign – Base 1 Screen

Section C – V/T – Inpatient – Foreign – Base 2 Screen


Section C – V/T – Inpatient – Foreign – Base 3 Screen

Section C – V/T – Inpatient – Foreign – Base 4 Screen

Section C – V/T – Foreign –Number of Groups Screen

Section C – V/T – Foreign – Groups – Base 1 Screen



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