| National Provider Identifier [NPI]: | 1811937782 |
| Last Name Of The Provider | PAYNE |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4631 RIDGE AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 45209 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 641 |
| Number Of Medicare Beneficiaries | 142 |
| Total Submitted Charge Amount | 59369 |
| Total Medicare Allowed Amount | 37846.93 |
| Total Medicare Payment Amount | 26426.97 |
| Total Medicare Standardized Payment Amount | 27493.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 5235 |
| Total Drug Medicare AllowedAmount | 2884.8 |
| Total Drug Medicare PaymentAmount | 2824.01 |
| Total Drug Medicare Standardized Payment Amount | 2824.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 568 |
| Number Of Medicare Beneficiaries With Medical Services | 142 |
| Total Medical Submitted Charge Amount | 54134 |
| Total Medical Medicare Allowed Amount | 34962.13 |
| Total Medical Medicare Payment Amount | 23602.96 |
| Total Medical Medicare Standardized Payment Amount | 24669.47 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | 119 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1598 |