TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change- phone

TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form

OMB: 0720-0008

IC ID: 236142

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change- phone
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 0720-0008 - phone script.docx No   Paper Only

Defense and National Security Operational Defense

DHA-07, Military Health Information System  78 FR 69076

1,261,151 0
   
Individuals or Households
 
   100 %

  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 2,522,302 0 0 2,522,302 0 0
Annual IC Time Burden (Hours) 630,576 0 0 630,576 0 0
Annual IC Cost Burden (Dollars) 4,571,672 0 0 4,571,672 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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