National Provider Identifier [NPI]: |
1124080403 |
Last Name Of The Provider |
KINCAID |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 BELLINGER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAU CLAIRE |
Zip Code Of The Provider |
547035222 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
4489 |
Number Of Medicare Beneficiaries |
1575 |
Total Submitted Charge Amount |
1852525 |
Total Medicare Allowed Amount |
277548.19 |
Total Medicare Payment Amount |
200881.02 |
Total Medicare Standardized Payment Amount |
213338.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
4489 |
Number Of Medicare Beneficiaries With Medical Services |
1575 |
Total Medical Submitted Charge Amount |
1852525 |
Total Medical Medicare Allowed Amount |
277548.19 |
Total Medical Medicare Payment Amount |
200881.02 |
Total Medical Medicare Standardized Payment Amount |
213338.34 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
469 |
Number Of Beneficiaries Age 75 to 84 |
565 |
Number Of Beneficiaries Age Greater 84 |
413 |
Number Of Female Beneficiaries |
713 |
Number Of Male Beneficiaries |
862 |
Number Of Non Hispanic White Beneficiaries |
1544 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
1244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
331 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6817 |