| National Provider Identifier [NPI]: | 1043355837 |
| Last Name Of The Provider | EDOUARD |
| First Name Of The Provider | MIRIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | ACNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9300 DEWITT LOOP |
| Street Address 2 Of The Provider | WARRIOR PAVILION BLDG 808 |
| City Of The Provider | FORT BELVOIR |
| Zip Code Of The Provider | 220605285 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 299 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 23405.72 |
| Total Medicare Allowed Amount | 18670.84 |
| Total Medicare Payment Amount | 14637.47 |
| Total Medicare Standardized Payment Amount | 14649.65 |
| 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 | 4 |
| Number Of Medical Services | 299 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 23405.72 |
| Total Medical Medicare Allowed Amount | 18670.84 |
| Total Medical Medicare Payment Amount | 14637.47 |
| Total Medical Medicare Standardized Payment Amount | 14649.65 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 86 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| 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 | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.3025 |