| National Provider Identifier [NPI]: | 1093819732 |
| Last Name Of The Provider | HAUGHN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 117 W PATERSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490072557 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 633 |
| Number Of Medicare Beneficiaries | 369 |
| Total Submitted Charge Amount | 53037 |
| Total Medicare Allowed Amount | 41743.06 |
| Total Medicare Payment Amount | 18670.56 |
| Total Medicare Standardized Payment Amount | 19622.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 557 |
| Total Drug Medicare AllowedAmount | 369.76 |
| Total Drug Medicare PaymentAmount | 360.21 |
| Total Drug Medicare Standardized Payment Amount | 360.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 618 |
| Number Of Medicare Beneficiaries With Medical Services | 369 |
| Total Medical Submitted Charge Amount | 52480 |
| Total Medical Medicare Allowed Amount | 41373.3 |
| Total Medical Medicare Payment Amount | 18310.35 |
| Total Medical Medicare Standardized Payment Amount | 19261.99 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 274 |
| Number Of Black or African American Beneficiaries | 75 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 254 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9237 |