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pdfPBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 1 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 2 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 3 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 4 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 5 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 6 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 6 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 7 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 7 of 215
PBP 2014 Data Entry System Screens
Section B - 1A - Inpatient Hospital-Acute – Base 8 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 8 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 9 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 9 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 10 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 10 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 11 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 11 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 12 Screen
Section B – 1A Inpatient Hospital Acute (B Only)-Base 1
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 12 of 215
PBP 2014 Data Entry System Screens
Section B – 1A Inpatient Hospital Acute (B Only)-Base 2
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 13 of 215
PBP 2014 Data Entry System Screens
Section B – 1A Inpatient Hospital Acute (B Only)-Base 3
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 14 of 215
PBP 2014 Data Entry System Screens
Section B – 1A Inpatient Hospital Acute (B Only)-Base 4
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 15 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 16 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 17 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 18 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 19 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 20 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 6 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 21 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 7 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 22 of 215
PBP 2014 Data Entry System Screens
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Section B – 1B - Inpatient Hospital Psychiatric – Base 8 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 23 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 9 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 24 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 10 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 25 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 11 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 26 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric – Base 12 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 27 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric (B-Only) – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 28 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric (B-Only) – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 29 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric (B-Only) – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 30 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric (B-Only) – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 31 of 215
PBP 2014 Data Entry System Screens
Section B – 1B - Inpatient Hospital Psychiatric (B-Only) – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 32 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 33 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 34 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 35 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 36 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 37 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 6 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 38 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility – Base 7 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 39 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility (B-Only) – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 40 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility (B-Only) – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 41 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility (B-Only) – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 42 of 215
PBP 2014 Data Entry System Screens
Section B – 2 – Skilled Nursing Facility (B-Only) – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 43 of 215
PBP 2014 Data Entry System Screens
Section B – 3 – Cardiac and Pulmonary Rehabilitation Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 44 of 215
PBP 2014 Data Entry System Screens
Section B – 3 – Cardiac and Pulmonary Rehabilitation Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 45 of 215
PBP 2014 Data Entry System Screens
Section B – 3 – Cardiac and Pulmonary Rehabilitation Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 46 of 215
PBP 2014 Data Entry System Screens
Section B – 3 – Cardiac and Pulmonary Rehabilitation Services – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 47 of 215
PBP 2014 Data Entry System Screens
Section B – 4A – Emergency Care – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 48 of 215
PBP 2014 Data Entry System Screens
Section B – 4A – Emergency Care – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 49 of 215
PBP 2014 Data Entry System Screens
Section B – 4A – Emergency Care – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 50 of 215
PBP 2014 Data Entry System Screens
Section B – 4A – Emergency Care – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 51 of 215
PBP 2014 Data Entry System Screens
Section B – 4B – Urgently Needed Care – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 52 of 215
PBP 2014 Data Entry System Screens
Section B – 4B – Urgently Needed Care – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 53 of 215
PBP 2014 Data Entry System Screens
Section B – 4B – Urgently Needed Care – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 54 of 215
PBP 2014 Data Entry System Screens
Section B – 4C – Worldwide Coverage – Base 1
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 55 of 215
PBP 2014 Data Entry System Screens
Section B – 4C – Worldwide Coverage – Base 2
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 56 of 215
PBP 2014 Data Entry System Screens
Section B – 4C – Worldwide Coverage – Base 3
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 57 of 215
PBP 2014 Data Entry System Screens
Section B – 5 – Partial Hospitalization – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 58 of 215
PBP 2014 Data Entry System Screens
Section B – 5 – Partial Hospitalization – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 59 of 215
PBP 2014 Data Entry System Screens
Section B – 6 – Home Health Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 60 of 215
PBP 2014 Data Entry System Screens
Section B – 6 – Home Health Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 61 of 215
PBP 2014 Data Entry System Screens
Section B – 6 – Home Health Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 62 of 215
PBP 2014 Data Entry System Screens
Section B – 6 –Home Health Services – MMP Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 63 of 215
PBP 2014 Data Entry System Screens
Section B – 6 –Home Health Services – MMP Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 64 of 215
PBP 2014 Data Entry System Screens
Section B – 7A – Primary Care Physician Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 65 of 215
PBP 2014 Data Entry System Screens
Section B – 7A – Primary Care Physician Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 66 of 215
PBP 2014 Data Entry System Screens
Section B – 7B – Chiropractic Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 67 of 215
PBP 2014 Data Entry System Screens
Section B – 7B – Chiropractic Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 68 of 215
PBP 2014 Data Entry System Screens
Section B – 7B – Chiropractic Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 69 of 215
PBP 2014 Data Entry System Screens
Section B – 7B – Chiropractic Services – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 70 of 215
PBP 2014 Data Entry System Screens
Section B – 7C – Occupational Therapy Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 71 of 215
PBP 2014 Data Entry System Screens
Section B – 7C – Occupational Therapy Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 72 of 215
PBP 2014 Data Entry System Screens
Section B – 7C – Occupational Therapy Services – MMP Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 73 of 215
PBP 2014 Data Entry System Screens
Section B – 7D – Physician Specialist Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 74 of 215
PBP 2014 Data Entry System Screens
Section B – 7D – Physician Specialist Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 75 of 215
PBP 2014 Data Entry System Screens
Section B – 7E – Mental Health Specialty Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 76 of 215
PBP 2014 Data Entry System Screens
Section B – 7E – Mental Health Specialty Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 77 of 215
PBP 2014 Data Entry System Screens
Section B – 7E – Mental Health Specialty Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 78 of 215
PBP 2014 Data Entry System Screens
Section B – 7F – Podiatry Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 79 of 215
PBP 2014 Data Entry System Screens
Section B – 7F – Podiatry Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 80 of 215
PBP 2014 Data Entry System Screens
Section B – 7F – Podiatry Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 81 of 215
PBP 2014 Data Entry System Screens
Section B – 7G – Other Health Care Professional – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 82 of 215
PBP 2014 Data Entry System Screens
Section B – 7G – Other Health Care Professional – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 83 of 215
PBP 2014 Data Entry System Screens
Section B – 7H – Psychiatric Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 84 of 215
PBP 2014 Data Entry System Screens
Section B – 7H – Psychiatric Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 85 of 215
PBP 2014 Data Entry System Screens
Section B – 7H – Psychiatric Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 86 of 215
PBP 2014 Data Entry System Screens
Section B – 7I – Physical Therapy and Speech Language Pathology Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 87 of 215
PBP 2014 Data Entry System Screens
Section B – 7I – Physical Therapy and Speech Language Pathology Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 88 of 215
PBP 2014 Data Entry System Screens
Section B – 7I – Physical Therapy and Speech Language Pathology Services – MMP Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 89 of 215
PBP 2014 Data Entry System Screens
Section B – 7I – Physical Therapy and Speech Language Pathology Services – MMP Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 90 of 215
PBP 2014 Data Entry System Screens
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 91 of 215
PBP 2014 Data Entry System Screens
Section B – 8A – Outpatient Diagnostic Procedures/Tests/Lab Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 92 of 215
PBP 2014 Data Entry System Screens
Section B – 8A – Outpatient Diagnostic Procedures/Tests/Lab Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 93 of 215
PBP 2014 Data Entry System Screens
Section B – 8A – Outpatient Diagnostic Procedures/Tests/Lab Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 94 of 215
PBP 2014 Data Entry System Screens
Section B – 8A – Outpatient Diagnostic Procedures/Tests/Lab Services – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 95 of 215
PBP 2014 Data Entry System Screens
Section B – 8B – Outpatient Diagnostic/Therapeutic Radiological Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 96 of 215
PBP 2014 Data Entry System Screens
Section B – 8B – Outpatient Diagnostic/Therapeutic Radiological Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 97 of 215
PBP 2014 Data Entry System Screens
Section B – 8B – Outpatient Diagnostic/Therapeutic Radiological Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 98 of 215
PBP 2014 Data Entry System Screens
Section B – 9A – Outpatient Hospital Services – Base 1 Screen
Section B – 9A – Outpatient Hospital Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 99 of 215
PBP 2014 Data Entry System Screens
Section B – 9A – Outpatient Hospital Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 100 of 215
PBP 2014 Data Entry System Screens
Section B – 9B – Ambulatory Surgical Center Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 101 of 215
PBP 2014 Data Entry System Screens
Section B – 9B – Ambulatory Surgical Center Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 102 of 215
PBP 2014 Data Entry System Screens
Section B – 9B – Ambulatory Surgical Center Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 103 of 215
PBP 2014 Data Entry System Screens
Section B – 9C – Outpatient Substance Abuse – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 104 of 215
PBP 2014 Data Entry System Screens
Section B – 9C – Outpatient Substance Abuse – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 105 of 215
PBP 2014 Data Entry System Screens
Section B – 9C – Outpatient Substance Abuse – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 106 of 215
PBP 2014 Data Entry System Screens
Section B – 9D – Outpatient Blood Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 107 of 215
PBP 2014 Data Entry System Screens
Section B – 9D – Outpatient Blood Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 108 of 215
PBP 2014 Data Entry System Screens
Section B – 10A – Ambulance Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 109 of 215
PBP 2014 Data Entry System Screens
Section B – 10A – Ambulance Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 110 of 215
PBP 2014 Data Entry System Screens
Section B – 10B – Transportation Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 111 of 215
PBP 2014 Data Entry System Screens
Section B – 10B – Transportation Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 112 of 215
PBP 2014 Data Entry System Screens
Section B – 10B – Transportation Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 113 of 215
PBP 2014 Data Entry System Screens
Section B – 11A – Durable Medical Equipment – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 114 of 215
PBP 2014 Data Entry System Screens
Section B – 11A – Durable Medical Equipment – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 115 of 215
PBP 2014 Data Entry System Screens
Section B – 11A – Durable Medical Equipment – MMP Services - Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 116 of 215
PBP 2014 Data Entry System Screens
Section B – 11A – Durable Medical Equipment – MMP Services - Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 117 of 215
PBP 2014 Data Entry System Screens
Section B – 11B – Prosthetics/Medical Supplies – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 118 of 215
PBP 2014 Data Entry System Screens
Section B – 11B – Prosthetics/Medical Supplies – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 119 of 215
PBP 2014 Data Entry System Screens
Section B – 11B – Prosthetics/Medical Supplies – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 120 of 215
PBP 2014 Data Entry System Screens
Section B – 11B – Prosthetics/Medical Supplies – MMP Services - Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 121 of 215
PBP 2014 Data Entry System Screens
Section B – 11C – Diabetic Supplies and Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 122 of 215
PBP 2014 Data Entry System Screens
Section B – 11C – Diabetic Supplies and Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 123 of 215
PBP 2014 Data Entry System Screens
Section B – 12 – End-Stage Renal Disease – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 124 of 215
PBP 2014 Data Entry System Screens
Section B – 12 – End-Stage Renal Disease – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 125 of 215
PBP 2014 Data Entry System Screens
Section B – 13A –Acupuncture and Other Alternative Therapies – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 126 of 215
PBP 2014 Data Entry System Screens
Section B – 13A –Acupuncture and Other Alternative Therapies – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 127 of 215
PBP 2014 Data Entry System Screens
Section B – 13A –Acupuncture and Other Alternative Therapies – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 128 of 215
PBP 2014 Data Entry System Screens
Section B – 13B – OTC Items and Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 129 of 215
PBP 2014 Data Entry System Screens
Section B – 13B – OTC Items and Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 130 of 215
PBP 2014 Data Entry System Screens
Section B – 13B – OTC Items and Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 131 of 215
PBP 2014 Data Entry System Screens
Section B – 13C –Meal Benefit – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 132 of 215
PBP 2014 Data Entry System Screens
Section B – 13C –Meal Benefit – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 133 of 215
PBP 2014 Data Entry System Screens
Section B – 13C –Meal Benefit – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 134 of 215
PBP 2014 Data Entry System Screens
Section B – 13D – Other 1 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 135 of 215
PBP 2014 Data Entry System Screens
Section B – 13D – Other 1 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 136 of 215
PBP 2014 Data Entry System Screens
Section B – 13D – Other 1 – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 137 of 215
PBP 2014 Data Entry System Screens
Section B – 13E – Other 2 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 138 of 215
PBP 2014 Data Entry System Screens
Section B – 13E – Other 2 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 139 of 215
PBP 2014 Data Entry System Screens
Section B – 13E – Other 2 – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 140 of 215
PBP 2014 Data Entry System Screens
Section B – 13F – Other 3 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 141 of 215
PBP 2014 Data Entry System Screens
Section B – 13F – Other 3 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 142 of 215
PBP 2014 Data Entry System Screens
Section B – 13F – Other 3 – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 143 of 215
PBP 2014 Data Entry System Screens
Section B – 13G – Dual Eligible SNPs with Highly Integrated Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 144 of 215
PBP 2014 Data Entry System Screens
Section B – 13G – Dual Eligible SNPs with Highly Integrated Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 145 of 215
PBP 2014 Data Entry System Screens
Section B – 13G – Dual Eligible SNPs with Highly Integrated Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 146 of 215
PBP 2014 Data Entry System Screens
Section B – 13H – Additional Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 147 of 215
PBP 2014 Data Entry System Screens
Section B – 13H – Additional Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 148 of 215
PBP 2014 Data Entry System Screens
Section B – 13H – Additional Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 149 of 215
PBP 2014 Data Entry System Screens
Section B – 13H – Additional Services – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 150 of 215
PBP 2014 Data Entry System Screens
Section B – 14A – Medicare-covered Preventive Services – Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 151 of 215
PBP 2014 Data Entry System Screens
Section B – 14B – Annual Physical Exam – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 152 of 215
PBP 2014 Data Entry System Screens
Section B – 14B – Annual Physical Exam – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 153 of 215
PBP 2014 Data Entry System Screens
Section B – 14B – Annual Physical Exam – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 154 of 215
PBP 2014 Data Entry System Screens
Section B – 14C – Supplemental Education/Health Management Programs – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 155 of 215
PBP 2014 Data Entry System Screens
Section B – 14C – Supplemental Education/Health Management Programs – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 156 of 215
PBP 2014 Data Entry System Screens
Section B – 14C – Supplemental Education/Health Management Programs – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 157 of 215
PBP 2014 Data Entry System Screens
Section B – 14C – Supplemental Education/Health Management Programs – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 158 of 215
PBP 2014 Data Entry System Screens
Section B – 14C – Supplemental Education/Health Management Programs – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 159 of 215
PBP 2014 Data Entry System Screens
Section B – 14D – Kidney Disease Education Services – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 160 of 215
PBP 2014 Data Entry System Screens
Section B – 14D – Kidney Disease Education Services – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 161 of 215
PBP 2014 Data Entry System Screens
Section B – 14D – Kidney Disease Education Services – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 162 of 215
PBP 2014 Data Entry System Screens
Section B – 14E – Diabetes Self-Management Training – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 163 of 215
PBP 2014 Data Entry System Screens
Section B – 14E – Diabetes Self-Management Training – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 164 of 215
PBP 2014 Data Entry System Screens
Section B – 14E – Diabetes Self-Management Training – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 165 of 215
PBP 2014 Data Entry System Screens
Section B – 15 – Medicare Part B Rx Drugs – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 166 of 215
PBP 2014 Data Entry System Screens
Section B – 15 – Medicare Part B Rx Drugs – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 167 of 215
PBP 2014 Data Entry System Screens
Section B – 15 – Medicare Part B Rx Drugs – Notes (Optional) Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 168 of 215
PBP 2014 Data Entry System Screens
Section B – 15 – Home Infusion Bundled Services Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 169 of 215
PBP 2014 Data Entry System Screens
Section B – 16A – Preventive Dental – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 170 of 215
PBP 2014 Data Entry System Screens
Section B – 16A – Preventive Dental – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 171 of 215
PBP 2014 Data Entry System Screens
Section B – 16A – Preventive Dental – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 172 of 215
PBP 2014 Data Entry System Screens
Section B – 16A – Preventive Dental – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 173 of 215
PBP 2014 Data Entry System Screens
Section B – 16A – Preventive Dental – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 174 of 215
PBP 2014 Data Entry System Screens
Section B – 16B – Comprehensive Dental – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 175 of 215
PBP 2014 Data Entry System Screens
Section B – 16B – Comprehensive Dental – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 176 of 215
PBP 2014 Data Entry System Screens
Section B – 16B – Comprehensive Dental – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 177 of 215
PBP 2014 Data Entry System Screens
Section B – 16B – Comprehensive Dental – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 178 of 215
PBP 2014 Data Entry System Screens
Section B – 16B – Comprehensive Dental – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 179 of 215
PBP 2014 Data Entry System Screens
Section B – 16B – Comprehensive Dental – Base 6 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 180 of 215
PBP 2014 Data Entry System Screens
Section B – 17A – Eye Exams – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 181 of 215
PBP 2014 Data Entry System Screens
Section B – 17A – Eye Exams – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 182 of 215
PBP 2014 Data Entry System Screens
Section B – 17A – Eye Exams – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 183 of 215
PBP 2014 Data Entry System Screens
Section B – 17B – Eye Wear – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 184 of 215
PBP 2014 Data Entry System Screens
Section B – 17B – Eye Wear – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 185 of 215
PBP 2014 Data Entry System Screens
Section B – 17B – Eye Wear – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 186 of 215
PBP 2014 Data Entry System Screens
Section B – 17B – Eye Wear – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 187 of 215
PBP 2014 Data Entry System Screens
Section B – 17B – Eye Wear – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 188 of 215
PBP 2014 Data Entry System Screens
Section B – 17B – Eye Wear – Base 6 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 189 of 215
PBP 2014 Data Entry System Screens
Section B – 18A – Hearing Exams – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 190 of 215
PBP 2014 Data Entry System Screens
Section B – 18A – Hearing Exams – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 191 of 215
PBP 2014 Data Entry System Screens
Section B – 18A – Hearing Exams – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 192 of 215
PBP 2014 Data Entry System Screens
Section B – 18A – Hearing Exams – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 193 of 215
PBP 2014 Data Entry System Screens
Section B – 18B – Hearing Aids – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 194 of 215
PBP 2014 Data Entry System Screens
Section B – 18B – Hearing Aids – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 195 of 215
PBP 2014 Data Entry System Screens
Section B – 18B – Hearing Aids – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 196 of 215
PBP 2014 Data Entry System Screens
Section B – 18B – Hearing Aids – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 197 of 215
PBP 2014 Data Entry System Screens
Section B – 18B – Hearing Aids – Base 5 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 198 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 199 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 200 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs – Base 3 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 201 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs – Base 4 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 202 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs – Notes (Optional) Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 203 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 1 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 204 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 1 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 205 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 2 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 206 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 2 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 207 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 3 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 208 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 3 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 209 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 4 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 210 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 4 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 211 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 5 – Base 1 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 212 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Outpatient Drugs-Group 5 – Base 2 Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 213 of 215
PBP 2014 Data Entry System Screens
Section B – 20 – Home Infusion Bundled Services – Screen
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 214 of 215
PBP 2014 Data Entry System Screens
Fu Associates, Ltd.
CY 2014 PBP – Section B
12/6/2012
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 215 of 215
| File Type | application/pdf |
| File Title | PBP 2014 Data Entry System Screens |
| Author | keirle |
| File Modified | 2012-12-06 |
| File Created | 2012-12-06 |