OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

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

IC 236141 under ICR 202506-0720-005 · OMB 0720-0008.

Documents and Forms
Document Name
Document Type
Other-Online Submission
Other-Online Submission
Information Collection (IC) Details

View Information Collection (IC)

TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change- web portal 0720-0008
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Online Submission BWE Portlet_Prime_Enrollment_20250721.pptx https://www.tricare.mil/bwe Yes Yes Fillable Fileable

Defense and National Security Operational Defense

DHA-07, Military Health Information System  78 FR 69076

113,125 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 226,250 0 0 0 0 226,250
Annual IC Time Burden (Hours) 56,563 0 0 0 0 56,563
Annual IC Cost Burden (Dollars) 410,078 0 0 0 0 410,078

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.
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