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) Modified 224 4480 0 Form and Instruction CMS-21
Form and Instruction CMS-21B
Form CMS-21
Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-37) Unchanged 224 4480 0 Form and Instruction CMS-37
Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64) Unchanged 224 8960 0
Total burden requested under this ICR: 672 17920 0  
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