| National Provider Identifier [NPI]: | 1780691949 |
| Last Name Of The Provider | PAYNE |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12833B RESEARCH BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 78750 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 711 |
| Number Of Medicare Beneficiaries | 401 |
| Total Submitted Charge Amount | 110660.56 |
| Total Medicare Allowed Amount | 93869.22 |
| Total Medicare Payment Amount | 67851.9 |
| Total Medicare Standardized Payment Amount | 70173.74 |
| 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 | 20 |
| Number Of Medical Services | 711 |
| Number Of Medicare Beneficiaries With Medical Services | 401 |
| Total Medical Submitted Charge Amount | 110660.56 |
| Total Medical Medicare Allowed Amount | 93869.22 |
| Total Medical Medicare Payment Amount | 67851.9 |
| Total Medical Medicare Standardized Payment Amount | 70173.74 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | 271 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 54 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.019 |