Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI (CMS-21 and CMS-21B) New 224 4480 0 Form and Instruction CMS-21
Form and Instruction CMS-21B
Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-37) New 224 4480 0 Form and Instruction CMS-37
Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64) New 224 8960 0 Form and Instruction CMS-64 (Summary)
Form and Instruction CMS-64.9 (base)
Total burden requested under this ICR: 672 17920 0  
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