Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64)

Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (MBES/CBES Forms CMS-21 and -21B, -37, and -64) -- (CMS-10529)

OMB: 0938-1265

IC ID: 213568

Documents and Forms

Document Name Document Type
Form CMS-64 Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64) Form
CMS-64 Medical Assistance Expenditures by Type of Service For t 64 Summary.pdf mbescbesval0.medicaid.gov/MBESCBES/Default.aspx Form
CMS-64 Medical Assistance Expenditures by Type of Service For t 64 Summary.pdf mbescbesval0.medicaid.gov/MBESCBES/Default.aspx Form
CMS-64 Unfilled Form 64 Blank Forms.pdf Form
CMS-64 Unfilled Form 64 Blank Forms.pdf Form
CMS-64.9 CMS 64.9 ARP 9817 Reinvest Form (FMAP Rate + 10%) 64.9 ARP 9817 Reinvest FMAP Rate +10%.pdf Form
CMS-64.9 CMS 64.9 ARP 9817 Reinvest Form (FMAP Rate + 10%) 64.9 ARP 9817 Reinvest FMAP Rate +10%.pdf Form
CMS-64.9 CMS-64.9 ARP 9817 CMS-64.9 ARP 9817.pdf Form
CMS-64.9 CMS-64.9 ARP 9817 CMS-64.9 ARP 9817.pdf Form
CMS-64.9 ARP Section 9811 (Line 47) Section 9811 CMS-64.9.pdf Form
CMS-64.9 ARP Section 9811 (Line 47) Section 9811 CMS-64.9.pdf Form
CMS-64.21U ARP Section 9821 (Line 26) Section 9821 CMS-64.21U.pdf Form
CMS-64.21U ARP Section 9821 (Line 26) Section 9821 CMS-64.21U.pdf Form
CMS-64.9 CMS-64.9 ARP 9817 Reinvest Form (Regular FMAP) 64.9 ARP 9817 Reinvest Regular FMAP.pdf Form
CMS-64.9 CMS-64.9 ARP 9817 Reinvest Form (Regular FMAP) 64.9 ARP 9817 Reinvest Regular FMAP.pdf Form
Crosswalk for the 64.9 ARP Section 9811 New line.xlsx CROSSWALK - Form CMS-64.9 IC Document
Crosswalk for the 64.9 ARP Section 9811 New line.xlsx CROSSWALK - Form CMS-64.9 IC Document
Crosswalk for the 64.21U ARP Section 9821 New line.xlsx CROSSWALK - Form CMS-64.21U IC Document
Crosswalk for the 64.21U ARP Section 9821 New line.xlsx CROSSWALK - Form CMS-64.21U IC Document