; (II) the application of all such adjustments in such fiscal year results in an appropriate distribution of performance payment incentives applied under this paragraph such that— (aa) providers and suppliers of air ambulance services with the highest rankings under subparagraph (A)(v) receive the highest payment increases under clause (i); and (bb) providers and suppliers of air ambulance services with the lowest rankings under subparagraph (A)(v) receive the lowest payment increases under clause (i), which may include zero