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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form
Modified
291548
72887
528431
Form
2876-1
TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form
Form
2876-2
TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form
Form
2876-3
TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form
TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change- phone
Removed
0
0
0
Instruction
TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change- web portal
Modified
226250
56563
410078
Other-Web Portal
Total burden requested under this ICR:
517798
129450
938509
To view an IC, click on IC Title