Download:
pdf |
pdf#19 VBID/MA Uniformity Flexibility/SSBCI
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 1 of 244
CY 2022 PBP Data Entry System Screens
#19 VBID Wellness and Health Care Planning
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 2 of 244
CY 2022 PBP Data Entry System Screens
#19 VBID Part C Rewards and Incentives # 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 3 of 244
CY 2022 PBP Data Entry System Screens
#19 VBID Part C Rewards and Incentives # 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 4 of 244
CY 2022 PBP Data Entry System Screens
#19 VBID Part C Rewards and Incentives # 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 5 of 244
#19 VBID- Cash or Monetary Rebates
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 6 of 244
#19a Reduction in Costs VBID/UF/SSBCI
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 7 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Package Type
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 8 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Target Population: VBID
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 9 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Disease States: UF
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 10 of 244
CY 2022 PBP Data Entry System Screens
#19a Additional Benefits for VBID/UF/SSBCI – Chronic Conditions: SSBCI
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 11 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – MMP Benefits
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 12 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 1 (Package Info)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 13 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 2 (OON/POS/Plan-level Deductible)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 14 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 3 (Reduced Coinsurance)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 15 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 4 (Reduced Coinsurance)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 16 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 5 (Reduced Coinsurance)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 17 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 6 (Reduced Coinsurance)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 18 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 7 (Reduced Coinsurance)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 19 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 8 (Reduced Deductible)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 20 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 9 (Reduced Deductible)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 21 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 10 (Reduced Copayment)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 22 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 11 (Reduced Copayment)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 23 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 12 (Reduced Copayment)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 24 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 13 (Reduced Copayment)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 25 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 14 (Reduced Copayment)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 26 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 15 (Reduced Specialist Coinsurance)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 27 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 16 (Reduced Specialist Deductible)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 28 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 17 (Reduced Specialist Copayment)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 29 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Base 18 (Retroactive Reimbursement)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 30 of 244
CY 2022 PBP Data Entry System Screens
#19a Reduced Cost Sharing for VBID/UF/SSBCI – Notes
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 31 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 32 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – Package Type
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 33 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – Target Population: VBID
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 34 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – Disease States: UF
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 35 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – Chronic Conditions: SSBCI (New Screen CY2022)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 36 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – MMP Benefits
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 37 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – Base 1 (Package Info)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 38 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI -Base 2 (OON/POS/Plan-level Deductible)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 39 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI – Base 3 (Retroactive Reimbursement)
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 40 of 244
CY 2022 PBP Data Entry System Screens
#19b Additional Benefits for VBID/UF/SSBCI - Notes
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 41 of 244
#19c VBID Hospice- Base 1
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 42 of 244
CY 2022 PBP Data Entry System Screens
#19c VBID Hospice- Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 43 of 244
CY 2022 PBP Data Entry System Screens
#19c VBID Hospice- Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 44 of 244
#19c VBID Hospice- Base 4
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 45 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 46 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 47 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 48 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 49 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 50 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 51 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 7
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 52 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 8
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 53 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 9
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 54 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 10
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 55 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 11
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 56 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1a Inpatient Hospital-Acute – Base 12
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 57 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 58 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 59 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 60 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 61 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 62 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 63 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 7
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 64 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 8
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 65 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 9
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 66 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 10
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 67 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 11
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 68 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19A #1b Inpatient Hospital Psychiatric – Base 12
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 69 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 1
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 70 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 2
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 71 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 3
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 72 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 4
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 73 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 5
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 74 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 6
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 75 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 7
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 76 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 8
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 77 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 9
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 78 of 244
VBID/UF/SSBCI 19A #2 SNF – Base 10
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 79 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #10b Transportation Services – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 80 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #10b Transportation Services – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 81 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #10b Transportation Services – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 82 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13a Acupuncture – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 83 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13a Acupuncture – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 84 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13a Acupuncture – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 85 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13b OTC Items – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 86 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13b OTC Items – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 87 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13b OTC Items – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 88 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13c Meal Benefit – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 89 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13c Meal Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 90 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13c Meal Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 91 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13d Other 1 – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 92 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13d Other 1 – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 93 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13d Other 1 – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 94 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13e Other 2 – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 95 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13e Other 2 – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 96 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13e Other 2 – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 97 of 244
VBID/UF/SSBCI 19B #13f Other 3 – Base 1
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 98 of 244
VBID/UF/SSBCI 19B #13f Other 3 – Base 2
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 99 of 244
VBID/UF/SSBCI 19B #13f Other 3 – Base 3
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 100 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Non-Primarily Health Related Benefits for the Chronically III-Type
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 101 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Food and Produce – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 102 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Food and Produce – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 103 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Food and Produce – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 104 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Meals (beyond limited basis) – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 105 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Meals (beyond limited basis) – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 106 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Meals (beyond limited basis) – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 107 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Pest Control – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 108 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Pest Control – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 109 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Pest Control – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 110 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Transportation for Non-Medical Needs – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 111 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Transportation for Non-Medical Needs – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 112 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Transportation for Non-Medical Needs – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 113 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Indoor Air Quality Equipment and Services – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 114 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Indoor Air Quality Equipment and Services – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 115 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Indoor Air Quality Equipment and Services – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 116 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Social Needs Benefit – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 117 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Social Needs Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 118 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Social Needs Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 119 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Complementary Therapies – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 120 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Complementary Therapies – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 121 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Complementary Therapies – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 122 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Services Supporting Self-Direction – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 123 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Services Supporting Self-Direction – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 124 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Services Supporting Self-Direction – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 125 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Structural Home Modifications – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 126 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Structural Home Modifications – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 127 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Structural Home Modifications – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 128 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i General Supports for Living – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 129 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i General Supports for Living – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 130 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i General Supports for Living - Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 131 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Non-Primarily Health Related Benefits for the Chronically III, Other
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 132 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 1 Non-Primarily Health Related Benefit – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 133 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 1 Non-Primarily Health Related Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 134 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 1 Non-Primarily Health Related Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 135 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 2 Non-Primarily Health Related Benefits – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 136 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 2 Non-Primarily Health Related Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 137 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 2 Non-Primarily Health Related Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 138 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 3 Non-Primarily Health Related Benefit – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 139 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 3 Non-Primarily Health Related Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 140 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 3 Non-Primarily Health Related Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 141 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 4 Non-Primarily Health Related Benefit – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 142 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 4 Non-Primarily Health Related Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 143 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 4 Non-Primarily Health Related Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 144 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 5 Non-Primarily Health Related Benefit – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 145 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 5 Non-Primarily Health Related Benefit – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 146 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #13i Other 5 Non-Primarily Health Related Benefit – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 147 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14b Annual Physical Exam – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 148 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14b Annual Physical Exam – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 149 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14b Annual Physical Exam – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 150 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 151 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 152 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 153 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 154 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 155 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 156 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 7
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 157 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 8
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 158 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 9
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 159 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 10
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 160 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 11
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 161 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 12
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 162 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 13
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 163 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 14
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 164 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 15
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 165 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #14c Other Defined Supplemental Benefits – Base 16
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 166 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16a Preventive Dental – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 167 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16a Preventive Dental – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 168 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16a Preventive Dental – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 169 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16a Preventive Dental – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 170 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16a Preventive Dental – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 171 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16b Comprehensive Dental – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 172 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16b Comprehensive Dental – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 173 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16b Comprehensive Dental – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 174 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16b Comprehensive Dental – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 175 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16b Comprehensive Dental – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 176 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #16b Comprehensive Dental – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 177 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17a Eye Exams – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 178 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17a Eye Exams – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 179 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17a Eye Exams – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 180 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17b Eyewear – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 181 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17b Eyewear – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 182 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17b Eyewear – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 183 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17b Eyewear – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 184 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17b Eyewear – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 185 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #17b Eyewear – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 186 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18a Hearing Exams – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 187 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18a Hearing Exams – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 188 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18a Hearing Exams – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 189 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18a Hearing Exams – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 190 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18b Hearing Aids – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 191 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18b Hearing Aids – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 192 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18b Hearing Aids – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 193 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18b Hearing Aids – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 194 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #18b Hearing Aids – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 195 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #3 Cardiac and Pulmonary Rehabilitation Services – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 196 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #3 Cardiac and Pulmonary Rehabilitation Services – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 197 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #3 Cardiac and Pulmonary Rehabilitation Services – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 198 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #3 Cardiac and Pulmonary Rehabilitation Services – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 199 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #4c Worldwide Emergency/Urgent Coverage – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 200 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #4c Worldwide Emergency/Urgent Coverage – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 201 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #4c Worldwide Emergency/Urgent Coverage – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 202 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #7b Chiropractic Services – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 203 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #7b Chiropractic Services – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 204 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #7b Chiropractic Services – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 205 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #7f Podiatry Services – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 206 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #7f Podiatry Services – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 207 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #7f Podiatry Services – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 208 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #9d Outpatient Blood Services – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 209 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #9d Outpatient Blood Services – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 210 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 211 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 212 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 213 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 214 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 215 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 216 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 7
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 217 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 8
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 218 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 9
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 219 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 10
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 220 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 11
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 221 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1a Inpatient Hospital-Acute – Base 12
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 222 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 1
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 223 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 2
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 224 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 3
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 225 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 4
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 226 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 5
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 227 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 6
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 228 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 7
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 229 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 8
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 230 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 9
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 231 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 10
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 232 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 11
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 233 of 244
CY 2022 PBP Data Entry System Screens
VBID/UF/SSBCI 19B #1b Inpatient Hospital Psychiatric – Base 12
Softrams
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 234 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 1
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 235 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 2
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 236 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 3
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 237 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 4
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 238 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 5
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 239 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 6
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 240 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 7
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 241 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 8
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 242 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 9
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 243 of 244
VBID/UF/SSBCI 19B #2 SNF – Base 10
Softrams
CY 2022 PBP Data Entry System Screens
CY2022 PBP – Section B VBID/UF/SSBCI
12/02/2020
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 244 of 244
File Type | application/pdf |
File Title | CY 2022 PBP Data Entry System Screens |
Author | Softrams |
File Modified | 2020-11-30 |
File Created | 2020-11-25 |