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) Unchanged 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) Modified 224 4480 0 Form CMS 37.3
Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64) Modified 224 8960 0 Form Form CMS 64.9VIII
Form CMS 64.9 BASE
Form CMS 64.9T
Form CMS 64.21
Form CMS 64.21U
Total burden requested under this ICR: 672 17920 0  
To view an IC, click on IC Title