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We derive this estimate from the number of applications received during the CY 2023 QCDR self-nomination period for the CY 2024 performance period/2026 MIPS payment year, while anticipating that: (1) some existing QCDRs may face remedial action and would need to complete the full self-nomination ( process for the CY 2025 performance period/2027 MIPS payment year, and (2) several new QCDR self-nominations