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
Form 2876-2
Form 2876-3
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  
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