CMS-R-262 CY 2018 PBP Data Entry System Screens - Section A

The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs) (CMS-R-262)

Appendix_C_PBP_2018_ screenshots_section_a_and_upload_2016_12_12_508

CY2018 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262)

OMB: 0938-0763

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Section A-1

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 1 of 8

Section A-2

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 2 of 8

Section A-3

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 3 of 8

Section A-4

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 4 of 8

Section A-5

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 5 of 8

Section A-6

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 6 of 8

Section A-7

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 7 of 8

Section A-General

Fu Associates, Ltd.

CY 2018 PBP Data Entry System Screens

CY2018 PBP – Section A
12/12/2016
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 8 of 8


File Typeapplication/pdf
File TitleCY 2018 PBP Data Entry System Screens - Section A and Upload
AuthorMichelle Hsu
File Modified2017-01-03
File Created2017-01-03

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