| National Provider Identifier [NPI]: | 1013091958 |
| Last Name Of The Provider | KINSLEY |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4715 VALLEY EAST BLVD |
| Street Address 2 Of The Provider | SUITE 3 |
| City Of The Provider | ARCATA |
| Zip Code Of The Provider | 955213584 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 13450 |
| Number Of Medicare Beneficiaries | 1926 |
| Total Submitted Charge Amount | 1355716 |
| Total Medicare Allowed Amount | 784448.41 |
| Total Medicare Payment Amount | 551862.46 |
| Total Medicare Standardized Payment Amount | 524810.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 99 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 2664 |
| Total Drug Medicare AllowedAmount | 1850.91 |
| Total Drug Medicare PaymentAmount | 1439.44 |
| Total Drug Medicare Standardized Payment Amount | 1439.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 13351 |
| Number Of Medicare Beneficiaries With Medical Services | 1926 |
| Total Medical Submitted Charge Amount | 1353052 |
| Total Medical Medicare Allowed Amount | 782597.5 |
| Total Medical Medicare Payment Amount | 550423.02 |
| Total Medical Medicare Standardized Payment Amount | 523371.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 971 |
| Number Of Beneficiaries Age 75 to 84 | 556 |
| Number Of Beneficiaries Age Greater 84 | 237 |
| Number Of Female Beneficiaries | 1001 |
| Number Of Male Beneficiaries | 925 |
| Number Of Non Hispanic White Beneficiaries | 1790 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 55 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1712 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 214 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8476 |