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Award Fee Provider Survey
Award Fee Provider Survey
OMB: 0720-0048
IC ID: 194123
OMB.report
DOD/DODOASHA
OMB 0720-0048
ICR 201710-0720-001
IC 194123
( )
Documents and Forms
Document Name
Document Type
TRICARE Provider SatSurvey _TeleInstrument 19May17.doc
Other-Telesurvey Script
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Award Fee Provider Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Telesurvey Script
TRICARE Provider SatSurvey _TeleInstrument 19May17.doc
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Defense and National Security
Subfunction:
Operational Defense
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,224
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,224
0
0
0
0
1,224
Annual IC Time Burden (Hours)
102
0
0
0
0
102
Annual IC Cost Burden (Dollars)
4,415
0
1,473
0
0
2,942
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
