| National Provider Identifier [NPI]: | 1093835829 |
| Last Name Of The Provider | KINCAID |
| First Name Of The Provider | JESSE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 HOSPITAL PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOLDOTNA |
| Zip Code Of The Provider | 996697559 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 212 |
| Number Of Services | 6762 |
| Number Of Medicare Beneficiaries | 2488 |
| Total Submitted Charge Amount | 927476 |
| Total Medicare Allowed Amount | 308536.18 |
| Total Medicare Payment Amount | 226781.48 |
| Total Medicare Standardized Payment Amount | 173130.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 370 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1565 |
| Total Drug Medicare AllowedAmount | 375.88 |
| Total Drug Medicare PaymentAmount | 263.8 |
| Total Drug Medicare Standardized Payment Amount | 263.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 209 |
| Number Of Medical Services | 6392 |
| Number Of Medicare Beneficiaries With Medical Services | 2488 |
| Total Medical Submitted Charge Amount | 925911 |
| Total Medical Medicare Allowed Amount | 308160.3 |
| Total Medical Medicare Payment Amount | 226517.68 |
| Total Medical Medicare Standardized Payment Amount | 172866.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 413 |
| Number Of Beneficiaries Age 65 to 74 | 1176 |
| Number Of Beneficiaries Age 75 to 84 | 659 |
| Number Of Beneficiaries Age Greater 84 | 240 |
| Number Of Female Beneficiaries | 1440 |
| Number Of Male Beneficiaries | 1048 |
| Number Of Non Hispanic White Beneficiaries | 2245 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 151 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1862 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 626 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.13 |