The TRICARE Management Activity, Defense Health Information Management System (DHIMS) is responsible for managing the acquisition, development, deployment and maintenance of the systems that comprise the military’s electronic health record (EHR). For more than 13 years, Axiom has provided financial management support services to DHIMS—processing, recording, and reconciling each financial transaction for a current annual budget in excess of $450 million. Throughout the Planning, Programming, Budget, and Execution cycle, AXIOM’s financial management team uses spend plans, budget execution tracking sheets, obligation plans, unfunded requirements (UFRs) and other standardized tools and processes to help the government manage the DHIMS’s budget. In addition, Axiom provides input and quality assurance reviews and incorporates DHIMS’s acquisition strategies into the DoD Program Objective Memorandum (POM) process. DHIMS’s POM submission serves as the foundation for the annual Budget Estimate Submission (BES) and the President’s Budget (PB), including the IT300 exhibits. Having prepared the last 12 POM, BES, and PB submissions, the Axiom team maintains the historical knowledge of the program’s sustainment needs and capabilities incorporating all elements of functionality, costs, and schedule. These elements are created or validated annually and are the foundation of DHIMS’s budget.