Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
2027 Performance Period/2029 MIPS Payment Year	New	141690	592889	0	Form and Instruction	Appendix A
					Form and Instruction	Appendix B
					Form and Instruction	Appendix C
					Form and Instruction	Appendix D
					Form and Instruction	Appendix E
					Form and Instruction	Appendix F
					Form and Instruction	Appendix G
					Form and Instruction	Appendix H
					Form and Instruction	Appendix I
					Form and Instruction	Appendix J
					Form and Instruction	Appendix K
					Form and Instruction	Appendix L
CY 2026 Performance Period/2028 MIPS Payment Year	Modified	141690	591156	0	Form and Instruction	Appendix A
					Form and Instruction	Appendix B
					Form and Instruction	Appendix C
					Form and Instruction	Appendix D
					Form and Instruction	Appendix E
					Form and Instruction	Appendix F
					Form and Instruction	Appendix G
					Form and Instruction	Appendix H
					Form and Instruction	Appendix I
					Form and Instruction	Appendix J
					Form and Instruction	Appendix K
					Form and Instruction	Appendix L
Total burden requested under this ICR:		283380	1184045	0
To view an IC, click on IC Title