Cms-r-262 Prescription Drugs Section-actuarially Equivalent-deduct
The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)
Appendix_C_-_PBP_2008_screenshots_Medicare_Rx_Drugs_ae
The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)
OMB: 0938-0763
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-0763 can be found here:
Document [doc]
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PBP 2008 Data Entry System Screens
Medicare Prescription Drugs Section – Actuarially Equivalent – Deductible and Pre-ICL Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – Pre-ICL Tier Label Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – Pre-ICL Tier Location Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – Pre-ICL Tier Cost Share Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – Pre-ICL Tier Coinsurance Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – Pre-ICL Tier Copayment Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – OOP Threshold Screen
Medicare Prescription Drugs Section – Actuarially Equivalent – Post-OOP Threshold Tier Screen
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| File Type | application/msword |
| File Modified | 2006-12-28 |
| File Created | 2006-12-28 |
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