CY2011 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_PBP_2011_screenshots_sec_a_121709_final

CY2011 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262

OMB: 0938-0763

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PBP 2011 Mock-up Data Entry System Screens

SECTION A – A-1 SCREEN

Appendix C

CY 2011 PBP PRA Package – Section A

Page 1 of 4

PBP 2011 Mock-up Data Entry System Screens

SECTION A – A-2 SCREEN

Appendix C

CY 2011 PBP PRA Package – Section A

Page 2 of 4

PBP 2011 Mock-up Data Entry System Screens

SECTION A – A-3 SCREEN

SECTION A – A-4 SCREEN
Appendix C

CY 2011 PBP PRA Package – Section A

Page 3 of 4

PBP 2011 Mock-up Data Entry System Screens

Appendix C

CY 2011 PBP PRA Package – Section A

Page 4 of 4


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