| National Provider Identifier [NPI]: | 1215021191 |
| Last Name Of The Provider | HAUGHTON |
| First Name Of The Provider | ADRIENNE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 604 E PARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LONG BEACH |
| Zip Code Of The Provider | 115612505 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1062 |
| Number Of Medicare Beneficiaries | 363 |
| Total Submitted Charge Amount | 213780 |
| Total Medicare Allowed Amount | 88768.64 |
| Total Medicare Payment Amount | 65559.3 |
| Total Medicare Standardized Payment Amount | 57287.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 7490 |
| Total Drug Medicare AllowedAmount | 7043.67 |
| Total Drug Medicare PaymentAmount | 5330.84 |
| Total Drug Medicare Standardized Payment Amount | 5330.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1008 |
| Number Of Medicare Beneficiaries With Medical Services | 363 |
| Total Medical Submitted Charge Amount | 206290 |
| Total Medical Medicare Allowed Amount | 81724.97 |
| Total Medical Medicare Payment Amount | 60228.46 |
| Total Medical Medicare Standardized Payment Amount | 51956.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 271 |
| Number Of Male Beneficiaries | 92 |
| Number Of Non Hispanic White Beneficiaries | 332 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0743 |