National Provider Identifier [NPI]: |
1144397860 |
Last Name Of The Provider |
KINCAID |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
545 S BOEHNE CAMP RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVANSVILLE |
Zip Code Of The Provider |
477123703 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1627 |
Number Of Medicare Beneficiaries |
321 |
Total Submitted Charge Amount |
156130 |
Total Medicare Allowed Amount |
100639.82 |
Total Medicare Payment Amount |
69130.92 |
Total Medicare Standardized Payment Amount |
73762.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
378 |
Number Of Medicare Beneficiaries With Drug Services |
141 |
Total Drug Submitted ChargeAmount |
18474 |
Total Drug Medicare AllowedAmount |
12631.01 |
Total Drug Medicare PaymentAmount |
11647.21 |
Total Drug Medicare Standardized Payment Amount |
11647.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1249 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
137656 |
Total Medical Medicare Allowed Amount |
88008.81 |
Total Medical Medicare Payment Amount |
57483.71 |
Total Medical Medicare Standardized Payment Amount |
62115.23 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
302 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.879 |