Information Collection Request

Quality Payment Program/Merit-Based Incentive Payment System (MIPS) (CMS-10621)

ICR 201707-0938-006 · OMB 0938-1314 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10621 ?414.1440 Other Payer Advanced APM Identification: Other Payer Initiated Process Form and Instruction New Available
CMS-10621 CY 2018 PRA Supporting Statement Part B -10-12 clean.doc Supporting Statement B Uploaded 2017-10-12 Available
CMS-10621 MIPS CY 2018 PRA Part A - 20171012.docx Supporting Statement A Uploaded 2017-10-12 Available

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved 03/31/2020
1,689,076 0 1,689,076
10,947,453 0 10,947,453
0 0 0







Reginfo record details
  No