CY2010 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262

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

Appendix C - MTMP screenshots_2008_12_15

CY2010 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262

OMB: 0938-0763

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MTMP Screenshots
CY 2010 MTMP Submission Start Page

CY 2010 MTMP - Enter/Edit screen

CY 2010 PRA Package – MTMP

Page 1 of 7

CY 2010 MTMP - Enter/Edit - Multiple Chronic Diseases screen

The minimum number of chronic
conditions must be 2 or 3.

CY 2010 MTMP - Enter/Edit - Multiple Covered Part D Drugs screen

The minimum number of Part D
drugs covered must be at least 2
and no greater than 8.

CY 2010 PRA Package – MTMP

Page 2 of 7

CY 2010 MTMP - Enter/Edit screen: Identification, Enrollment/Disenrollment and
Interventions

CY 2010 PRA Package – MTMP

Page 3 of 7

CY 2010 MTMP – Enter/Edit Fees, Outcomes Measured, and Other Information

CY 2010 PRA Package – MTMP

Page 4 of 7

MTMP CY 2010 – Verify Submission
CY 2010 PRA Package – MTMP

Page 5 of 7

MTMP CY 2010 – Submission Confirmation
CY 2010 PRA Package – MTMP

Page 6 of 7

CY 2010 PRA Package – MTMP

Page 7 of 7


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AuthorCMS
File Modified2008-12-18
File Created2008-12-18

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