| National Provider Identifier [NPI]: | 1902876071 |
| Last Name Of The Provider | LIMJOCO |
| First Name Of The Provider | JUAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 GRANT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GARY |
| Zip Code Of The Provider | 464026001 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1866 |
| Number Of Medicare Beneficiaries | 841 |
| Total Submitted Charge Amount | 300550.16 |
| Total Medicare Allowed Amount | 58256.35 |
| Total Medicare Payment Amount | 45586.99 |
| Total Medicare Standardized Payment Amount | 38240.21 |
| 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 | 28 |
| Number Of Medical Services | 1866 |
| Number Of Medicare Beneficiaries With Medical Services | 841 |
| Total Medical Submitted Charge Amount | 300550.16 |
| Total Medical Medicare Allowed Amount | 58256.35 |
| Total Medical Medicare Payment Amount | 45586.99 |
| Total Medical Medicare Standardized Payment Amount | 38240.21 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 230 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 498 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 277 |
| Number Of Black or African American Beneficiaries | 521 |
| 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 | 507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 334 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1903 |