Information Collection

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

IC 236141 under ICR 202204-0720-001 · OMB 0720-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0720-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
BWE_Screenshots_2022.pptx www.dmdc.osd.mil/appj/bwe/indexAction.do	Other-Web Portal
BWE_Screenshots_2022.pptx www.dmdc.osd.mil/appj/bwe/indexAction.do	Other-Web Portal

IC Title:

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

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web Portal			BWE_Screenshots_2022.pptx	https://www.dmdc.osd.mil/appj/bwe/indexAction.do	Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: DHA-07, Military Health Information System

FR Citation: 78 FR 69076

Number of Respondents: 113,125

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	226,250	226,250
Annual IC Time Burden (Hours)	56,563	56,563
Annual IC Cost Burden (Dollars)	410,078	410,078

Documents for IC

table that charts IC Documents
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.