National Provider Identifier [NPI]: |
1255447959 |
Last Name Of The Provider |
LIM |
First Name Of The Provider |
BOON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
147 GETTYS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GETTYSBURG |
Zip Code Of The Provider |
173252534 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
551 |
Number Of Medicare Beneficiaries |
525 |
Total Submitted Charge Amount |
137111 |
Total Medicare Allowed Amount |
84054.69 |
Total Medicare Payment Amount |
63677.27 |
Total Medicare Standardized Payment Amount |
63146.77 |
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 |
15 |
Number Of Medical Services |
551 |
Number Of Medicare Beneficiaries With Medical Services |
525 |
Total Medical Submitted Charge Amount |
137111 |
Total Medical Medicare Allowed Amount |
84054.69 |
Total Medical Medicare Payment Amount |
63677.27 |
Total Medical Medicare Standardized Payment Amount |
63146.77 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
303 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
472 |
Number Of Black or African American Beneficiaries |
41 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
419 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1958 |