| National Provider Identifier [NPI]: | 1821027798 |
| Last Name Of The Provider | GAUTIER |
| First Name Of The Provider | KIRK |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1367 DOMINION PLAZA |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757031013 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 11023 |
| Number Of Medicare Beneficiaries | 2058 |
| Total Submitted Charge Amount | 1083779.26 |
| Total Medicare Allowed Amount | 439719.36 |
| Total Medicare Payment Amount | 317431.51 |
| Total Medicare Standardized Payment Amount | 391075.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 728 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 8101.74 |
| Total Drug Medicare AllowedAmount | 1688.93 |
| Total Drug Medicare PaymentAmount | 1238.09 |
| Total Drug Medicare Standardized Payment Amount | 1238.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 10295 |
| Number Of Medicare Beneficiaries With Medical Services | 2058 |
| Total Medical Submitted Charge Amount | 1075677.52 |
| Total Medical Medicare Allowed Amount | 438030.43 |
| Total Medical Medicare Payment Amount | 316193.42 |
| Total Medical Medicare Standardized Payment Amount | 389837.01 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 904 |
| Number Of Beneficiaries Age 75 to 84 | 713 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 940 |
| Number Of Male Beneficiaries | 1118 |
| Number Of Non Hispanic White Beneficiaries | 1993 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1873 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0718 |