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This variable is contained in the following files:
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.
Values: up to 3-digit numeric value
Source: CMS (HPMS files)
The PDSS Model file was new in 2021 and is retired after 2023. This PDSS Model file is not produced after 2023. Additional details regarding this CMS Innovation Center Model are available on the CMS website.