| National Provider Identifier [NPI]: | 1821183252 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 HOAG DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT BEACH |
| Zip Code Of The Provider | 926634162 |
| 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 | 207 |
| Number Of Services | 6192 |
| Number Of Medicare Beneficiaries | 2718 |
| Total Submitted Charge Amount | 786527.81 |
| Total Medicare Allowed Amount | 199718.88 |
| Total Medicare Payment Amount | 150655.62 |
| Total Medicare Standardized Payment Amount | 139532.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2195 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 5110 |
| Total Drug Medicare AllowedAmount | 655.9 |
| Total Drug Medicare PaymentAmount | 514.27 |
| Total Drug Medicare Standardized Payment Amount | 514.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 3997 |
| Number Of Medicare Beneficiaries With Medical Services | 2718 |
| Total Medical Submitted Charge Amount | 781417.81 |
| Total Medical Medicare Allowed Amount | 199062.98 |
| Total Medical Medicare Payment Amount | 150141.35 |
| Total Medical Medicare Standardized Payment Amount | 139018.06 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 1037 |
| Number Of Beneficiaries Age 75 to 84 | 958 |
| Number Of Beneficiaries Age Greater 84 | 538 |
| Number Of Female Beneficiaries | 1511 |
| Number Of Male Beneficiaries | 1207 |
| Number Of Non Hispanic White Beneficiaries | 2318 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 210 |
| Number Of Hispanic Beneficiaries | 100 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 67 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 354 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7552 |