| National Provider Identifier [NPI]: | 1194933861 |
| Last Name Of The Provider | EDSALL |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 320A CHARLES H DIMMOCK PKWY |
| Street Address 2 Of The Provider | SUITE 7 |
| City Of The Provider | COLONIAL HEIGHTS |
| Zip Code Of The Provider | 238342917 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 9441 |
| Number Of Medicare Beneficiaries | 1580 |
| Total Submitted Charge Amount | 514755 |
| Total Medicare Allowed Amount | 452862.01 |
| Total Medicare Payment Amount | 326505.55 |
| Total Medicare Standardized Payment Amount | 331953.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 253 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 21075 |
| Total Drug Medicare AllowedAmount | 20262.4 |
| Total Drug Medicare PaymentAmount | 15177.83 |
| Total Drug Medicare Standardized Payment Amount | 15177.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 9188 |
| Number Of Medicare Beneficiaries With Medical Services | 1580 |
| Total Medical Submitted Charge Amount | 493680 |
| Total Medical Medicare Allowed Amount | 432599.61 |
| Total Medical Medicare Payment Amount | 311327.72 |
| Total Medical Medicare Standardized Payment Amount | 316775.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 846 |
| Number Of Beneficiaries Age 75 to 84 | 474 |
| Number Of Beneficiaries Age Greater 84 | 188 |
| Number Of Female Beneficiaries | 912 |
| Number Of Male Beneficiaries | 668 |
| Number Of Non Hispanic White Beneficiaries | 1502 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1551 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8538 |