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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
CHIPRA 214 Option (ยงยง 435.4 and 457.320(c))
New
4101
4101
0
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)
Modified
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
122
14766
0
Total burden requested under this ICR:
76504319
21270403
0
To view an IC, click on IC Title
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