CMS-R-262 Medicare Prescription Drugs Section-Alternative
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_alt
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⚠️ Notice: This form may be outdated.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 – Alternative – Deductible Screen
Medicare Prescription Drugs Section – Alternative – Excluded Drugs and Pre-ICL Screen
Medicare Prescription Drugs Section – Alternative – Pre-ICL Label Screen
Medicare Prescription Drugs Section – Alternative – Pre-ICL Locations Screen
Medicare Prescription Drugs Section – Alternative – Pre-ICL Cost Share Screen
Medicare Prescription Drugs Section – Alternative – Pre-ICL Coinsurance Screen
Medicare Prescription Drugs Section – Alternative – Pre-ICL Copayment Screen
Medicare Prescription Drugs Section – Alternative – ICL Screen
Medicare Prescription Drugs Section – Alternative – Gap Tier Label Screen
Medicare Prescription Drugs Section – Alternative – Gap Tier Coverage Screen
Medicare Prescription Drugs Section – Alternative – Gap Tier Locations Screen
Medicare Prescription Drugs Section – Alternative – Gap Tier Cost Share Screen
Medicare Prescription Drugs Section – Alternative – Gap Tier Coinsurance Screen
Medicare Prescription Drugs Section – Alternative – Gap Tier Copayment Screen
Medicare Prescription Drugs Section – Alternative – OOP Threshold Screen
Medicare Prescription Drugs Section – Alternative – Post-OOP Threshold Tier Screen
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| File Type | application/msword |
| File Modified | 2007-01-08 |
| File Created | 2007-01-08 |
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