Copay

SAS Name
COPAY

This variable identifies the beneficiary copayment amount for the drug products covered by the Part D Senior Savings (PDSS) model. The insulin drug products (represented by the FRMLRY_RX_ID) covered as part of the PDSS have a different payment structure than other insulins (or other drug products) on the formulary.

Comments

The PDSS Model file was new in 2021. Additional details regarding this CMS Innovation Center Model are available on the CMS website.