; and (vi) for each such payment year specify a performance payment percentage point adjustment, in accordance with subparagraph (D)(ii), for each provider or supplier of air ambulance services to be applied under subparagraph (D)(i). (B) Performance Benchmarks Under the Program, for each performance period with respect to a payment year (beginning with payment year 2024), the Secretary shall establish a nationwide performance benchmark for each quality measure described in paragraph (17)(E). Such a benchmark, with respect to such a quality measure, shall be the average of the performance scores for all such providers and suppliers for such measure. (C) Composite performance quality scores Under the Program, for each performance period with respect to a payment year (beginning with payment year 2024), the Secretary shall determine a composite performance quality score for each provider or supplier of air ambulance services, based on the cumulative performance scores determined under subparagraph (A)(iii) for such provider or supplier and performance period. For purposes of ranking under subparagraph (A)(v), a provider or supplier of air ambulance services who does not submit required data to determine performance under this paragraph for a performance period for a year shall be treated as receiving a composite performance quality score of zero under this subparagraph for such period and shall be ranked accordingly under subparagraph (A)(v). (D) Performance payment (i) In general With respect to ambulance services furnished by a provider or supplier of air ambulance services during a payment year (beginning with 2024), the Secretary shall apply a performance payment percentage point adjustment to the percentage increase determined under paragraph (3)(B), after application of paragraphs (3)(C), (17)(F), and (19) and subparagraph (E) for a payment year (beginning with 2024). (ii) Performance payment percentage point adjustment The Secretary shall, in accordance with clause (iii), specify a performance payment