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

ICR 202401-0938-014

OMB: 0938-0763

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-R-262 CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) Form and Instruction	Modified
Appendix_A_CMS-R-262_CY2025_PBP_Sprtng_Stmnt_.docx Supporting Statement A	2024-01-25
Appendix_B_CY_2025 PBP List of Changes - 30 Days PRA.pdf Supplementary Document	2024-01-25
CY2025 PRA 60-day comments 01082024_final.docx Supplementary Document	2024-01-25

IC Document Collections

IC ID	Document Title	Status
43667	CY2023 Plan Benefit Package (PBP) Software and Formulary Submission (CMS-R-262) Form and Instruction	Modified