Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Periodic Renewal of Medicaid and CHIP Eligibility - Eligibility Notice (sections 435.916, 457.343, and 457.350) Unchanged 96 1536 0
Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350) Unchanged 25500000 8500000 0
Periodic Renewal of Medicaid and CHIP Eligibility - Recordkeeping (sections 435.916, 457.343, and 457.350) Unchanged 51000000 12750000 0
Web Sites (sections 435.1200 and 457.335) Unchanged 53 26606 0
Total burden requested under this ICR: 76500149 21278142 0  
To view an IC, click on IC Title