| National Provider Identifier [NPI]: | 1669430518 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1530 BESSIE AVE |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | TRACY |
| Zip Code Of The Provider | 953763080 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 7273 |
| Number Of Medicare Beneficiaries | 4138 |
| Total Submitted Charge Amount | 753662.75 |
| Total Medicare Allowed Amount | 213336.01 |
| Total Medicare Payment Amount | 157567.15 |
| Total Medicare Standardized Payment Amount | 151052.72 |
| 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 | 187 |
| Number Of Medical Services | 7273 |
| Number Of Medicare Beneficiaries With Medical Services | 4138 |
| Total Medical Submitted Charge Amount | 753662.75 |
| Total Medical Medicare Allowed Amount | 213336.01 |
| Total Medical Medicare Payment Amount | 157567.15 |
| Total Medical Medicare Standardized Payment Amount | 151052.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 692 |
| Number Of Beneficiaries Age 65 to 74 | 1432 |
| Number Of Beneficiaries Age 75 to 84 | 1249 |
| Number Of Beneficiaries Age Greater 84 | 765 |
| Number Of Female Beneficiaries | 2513 |
| Number Of Male Beneficiaries | 1625 |
| Number Of Non Hispanic White Beneficiaries | 1851 |
| Number Of Black or African American Beneficiaries | 199 |
| Number Of AsianPacific Islander Beneficiaries | 887 |
| Number Of Hispanic Beneficiaries | 1103 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | 80 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2000 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2138 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8771 |