Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
CY 2022 Performance Period/2024 MIPS Payment Year Burden Summary	Removed	0	0	0	Other-Appendix A1 (See Table 3): 2022 Qualified Registry Fact Sheet (Revised)
					Other-Appendix B1 (See Table 4): 2022 Qualified Clinical Data Registry (QCDR) Fact Sheet (Revised)
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	CMS-10621
					Form and Instruction	cms-10621
					Form and Instruction	cms-10621
					Form and Instruction	cms-10621
					Form and Instruction	CMS-10621
CY 2023 Performance Period/2025 MIPS Payment Year Burden Summary	Modified	159528	713860	0	Form and Instruction	Appendix A
					Form	Appendix B1
					Form and Instruction	Appendix C1
					Form and Instruction	Appendix D1
					Form and Instruction	Appendix E1
					Form and Instruction	Appendix F1
					Form and Instruction	Appendix G1
					Form and Instruction	Appendix H1
					Form and Instruction	Appendix I
					Form and Instruction	Appendix J
					Form and Instruction	Appendix K1
					Form and Instruction	Appendix L1
Total burden requested under this ICR:		159528	713860	0
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