| National Provider Identifier [NPI]: | 1003871518 |
| Last Name Of The Provider | PAYNE |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 115 HUSTON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHEPHERDSVILLE |
| Zip Code Of The Provider | 401657250 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 8214 |
| Number Of Medicare Beneficiaries | 1793 |
| Total Submitted Charge Amount | 498528 |
| Total Medicare Allowed Amount | 258470.28 |
| Total Medicare Payment Amount | 185807.23 |
| Total Medicare Standardized Payment Amount | 205563 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 305 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 12436 |
| Total Drug Medicare AllowedAmount | 6639.6 |
| Total Drug Medicare PaymentAmount | 6137.68 |
| Total Drug Medicare Standardized Payment Amount | 6137.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 7909 |
| Number Of Medicare Beneficiaries With Medical Services | 1793 |
| Total Medical Submitted Charge Amount | 486092 |
| Total Medical Medicare Allowed Amount | 251830.68 |
| Total Medical Medicare Payment Amount | 179669.55 |
| Total Medical Medicare Standardized Payment Amount | 199425.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 340 |
| Number Of Beneficiaries Age 65 to 74 | 777 |
| Number Of Beneficiaries Age 75 to 84 | 519 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 975 |
| Number Of Male Beneficiaries | 818 |
| Number Of Non Hispanic White Beneficiaries | 1729 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 1548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 245 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0797 |