| National Provider Identifier [NPI]: | 1295734747 |
| Last Name Of The Provider | FOUGNIE |
| First Name Of The Provider | KIRK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4331 CHURCHMAN AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402151164 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 7299 |
| Number Of Medicare Beneficiaries | 1058 |
| Total Submitted Charge Amount | 549833 |
| Total Medicare Allowed Amount | 223646.75 |
| Total Medicare Payment Amount | 169561.84 |
| Total Medicare Standardized Payment Amount | 204302.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4016 |
| Number Of Medicare Beneficiaries With Drug Services | 346 |
| Total Drug Submitted ChargeAmount | 64868 |
| Total Drug Medicare AllowedAmount | 46109.45 |
| Total Drug Medicare PaymentAmount | 35825.48 |
| Total Drug Medicare Standardized Payment Amount | 35825.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 3283 |
| Number Of Medicare Beneficiaries With Medical Services | 1058 |
| Total Medical Submitted Charge Amount | 484965 |
| Total Medical Medicare Allowed Amount | 177537.3 |
| Total Medical Medicare Payment Amount | 133736.36 |
| Total Medical Medicare Standardized Payment Amount | 168476.61 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 348 |
| Number Of Beneficiaries Age 75 to 84 | 402 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 712 |
| Number Of Male Beneficiaries | 346 |
| Number Of Non Hispanic White Beneficiaries | 978 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 962 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3596 |