CY2013 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_2013_screenshots_section_a_2011_12_08

CY2013 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262

OMB: 0938-0763

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PBP 2013 Data Entry System Screens

 
Section A‐ A‐1 Screen 

 
Fu Associates, Ltd.

 

CY 2013 PBP – Section A
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 1 of 6

PBP 2013 Data Entry System Screens

 
Section A‐ A‐2 Screen 

 
Fu Associates, Ltd.

 

CY 2013 PBP – Section A
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 2 of 6

PBP 2013 Data Entry System Screens

 
Section A‐ A‐3 Screen 

 
Fu Associates, Ltd.

 

CY 2013 PBP – Section A
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 3 of 6

PBP 2013 Data Entry System Screens

 
Section A‐ A‐4 Screen 

 
Fu Associates, Ltd.

 

CY 2013 PBP – Section A
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 4 of 6

PBP 2013 Data Entry System Screens

 
Section A‐ A‐5 Screen 

 
Fu Associates, Ltd.

 

CY 2013 PBP – Section A
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 5 of 6

PBP 2013 Data Entry System Screens

 
Section A‐ A‐6 Screen 

 

Fu Associates, Ltd.

 

CY 2013 PBP – Section A
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 6 of 6


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Authormeyer
File Modified2011-12-09
File Created2011-12-09

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