Non-FormularyGridMA-OnlyNot FDA-approvedStrength ofrecommendationis class I, IIa, IIbwith any efficacyor III if evidencefavor efficacyOveractiveBladder(OAB)IncompleteNotesMAPDBronchospasmrelated toCOPDDefaultduration -12/31/13MedicallyacceptedindicationTransitionalOverrideBEERsListNF, ST,TCSE,QLSharedVerbiageStrength ofrecommendationis III andevidence isinconclusive orineffectivePDPIncompleteSLA andSLAComplianceNon-FormularyDecisionNotesStep-TherapyPARequiredand BvsDUrgencyand casetypeIncompleteDiagnosisReviewNon-FormularyGridMA-OnlyNot FDA-approvedStrength ofrecommendationis class I, IIa, IIbwith any efficacyor III if evidencefavor efficacyOveractiveBladder(OAB)IncompleteNotesMAPDBronchospasmrelated toCOPDDefaultduration -12/31/13MedicallyacceptedindicationTransitionalOverrideBEERsListNF, ST,TCSE,QLSharedVerbiageStrength ofrecommendationis III andevidence isinconclusive orineffectivePDPIncompleteSLA andSLAComplianceNon-FormularyDecisionNotesStep-TherapyPARequiredand BvsDUrgencyand casetypeIncompleteDiagnosisReview

Medicare Overview/Incomplete/NF/ST/Off-Label - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Non-Formulary Grid
  2. MA-Only
  3. Not FDA-approved
  4. Strength of recommendation is class I, IIa, IIb with any efficacy or III if evidence favor efficacy
  5. Overactive Bladder (OAB)
  6. Incomplete Notes
  7. MAPD
  8. Bronchospasm related to COPD
  9. Default duration - 12/31/13
  10. Medically accepted indication
  11. Transitional Override
  12. BEERs List
  13. NF, ST, TCSE, QL
  14. Shared Verbiage
  15. Strength of recommendation is III and evidence is inconclusive or ineffective
  16. PDP
  17. Incomplete SLA and SLA Compliance
  18. Non-Formulary
  19. Decision Notes
  20. Step-Therapy
  21. PA Required and BvsD
  22. Urgency and case type
  23. Incomplete
  24. Diagnosis Review