| National Provider Identifier [NPI]: | 1568521516 |
| Last Name Of The Provider | PAYNE |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2406 BLUE RIDGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RALEIGH |
| Zip Code Of The Provider | 276076678 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 792 |
| Number Of Medicare Beneficiaries | 118 |
| Total Submitted Charge Amount | 123472.3 |
| Total Medicare Allowed Amount | 39638.31 |
| Total Medicare Payment Amount | 28291.51 |
| Total Medicare Standardized Payment Amount | 29889.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1988.05 |
| Total Drug Medicare AllowedAmount | 1047.51 |
| Total Drug Medicare PaymentAmount | 1021.28 |
| Total Drug Medicare Standardized Payment Amount | 1021.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 746 |
| Number Of Medicare Beneficiaries With Medical Services | 118 |
| Total Medical Submitted Charge Amount | 121484.25 |
| Total Medical Medicare Allowed Amount | 38590.8 |
| Total Medical Medicare Payment Amount | 27270.23 |
| Total Medical Medicare Standardized Payment Amount | 28868.09 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | 88 |
| 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 | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0988 |