| National Provider Identifier [NPI]: | 1548235856 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | BERNARD |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MBBCH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 E MASON ST |
| Street Address 2 Of The Provider | SUITE 4P57 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627011034 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 2814 |
| Number Of Medicare Beneficiaries | 867 |
| Total Submitted Charge Amount | 962419 |
| Total Medicare Allowed Amount | 248535 |
| Total Medicare Payment Amount | 185715.57 |
| Total Medicare Standardized Payment Amount | 189823.95 |
| 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 | 53 |
| Number Of Medical Services | 2814 |
| Number Of Medicare Beneficiaries With Medical Services | 867 |
| Total Medical Submitted Charge Amount | 962419 |
| Total Medical Medicare Allowed Amount | 248535 |
| Total Medical Medicare Payment Amount | 185715.57 |
| Total Medical Medicare Standardized Payment Amount | 189823.95 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 245 |
| Number Of Beneficiaries Age 75 to 84 | 306 |
| Number Of Beneficiaries Age Greater 84 | 257 |
| Number Of Female Beneficiaries | 398 |
| Number Of Male Beneficiaries | 469 |
| Number Of Non Hispanic White Beneficiaries | 839 |
| 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 | 754 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 46 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6633 |