| National Provider Identifier [NPI]: | 1164749917 |
| Last Name Of The Provider | GAUTHIER |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | RN, CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3333 BURNET AVE. |
| Street Address 2 Of The Provider | ML 11013 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452293039 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 245 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 148592 |
| Total Medicare Allowed Amount | 20631.18 |
| Total Medicare Payment Amount | 15595.58 |
| Total Medicare Standardized Payment Amount | 18689.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 148592 |
| Total Medical Medicare Allowed Amount | 20631.18 |
| Total Medical Medicare Payment Amount | 15595.58 |
| Total Medical Medicare Standardized Payment Amount | 18689.46 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 100 |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.845 |