Information Collection

§414.1330 and §414.1335 Qualified Registry or QCDR Submission Mechanism

IC 221779 under ICR 201606-0938-001 · OMB 0938-1314.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1314 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10621 List of Quality Performance Category Measures §414.1330 and §414.1335 Qualified Registry or QCDR Submission Mechanism	Form and Instruction
CMS-10621 List of Quality Performance Category Measures MIPS PRA Appendix A- List of Quality Performance Category Measures.docx	Form and Instruction

IC Title:

§414.1330 and §414.1335 Qualified Registry or QCDR Submission Mechanism

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR §414.1330 and §414.1335 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10621				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 214,590

Number of Respondents for Small Entity: 214,590

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	214,590	214,590
Annual IC Time Burden (Hours)	2,163,711	2,163,711
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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