Information Collection Request

Award Fee Provider Survey

ICR 201710-0720-001 · OMB 0720-0048 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
OPA_DMDC_Rec-Letter-Tricare-Award-Fee-Provider-Satisfaction-Survey-OMB_Aug_11_2017.pdf Supplementary Document Uploaded 2017-10-16 Available
TRICARE Award Fee Provider Survey_PAR_Chief Approved.docx Supplementary Document Uploaded 2017-10-16 Available
OMB Supporting Statement - Part B_27Apr17.docx Supporting Statement B Uploaded 2017-10-16 Available
TRICARE AwardFee provider OMB Supporting Statement - Part A_19May.docx Supporting Statement A Uploaded 2017-10-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
194123 Award Fee Provider Survey Other-Telesurvey Script Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved 12/31/2017
1,224 0 1,224
102 0 102
4,415 0 2,942





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1
table that charts list of burden
IC Title Form No. Form Name
Award Fee Provider Survey

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,224 1,224 0 0 0 0
Annual Time Burden (Hours) 102 102 0 0 0 0
Annual Cost Burden (Dollars) 4,415 2,942 0 1,473 0 0


Reginfo record details
  No