National Provider Identifier [NPI]: |
1154579241 |
Last Name Of The Provider |
LIM |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
727 DELANCEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191064002 |
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 |
20 |
Number Of Services |
482 |
Number Of Medicare Beneficiaries |
238 |
Total Submitted Charge Amount |
71300 |
Total Medicare Allowed Amount |
38074.72 |
Total Medicare Payment Amount |
23191.29 |
Total Medicare Standardized Payment Amount |
21978.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
2218 |
Total Drug Medicare AllowedAmount |
1386.34 |
Total Drug Medicare PaymentAmount |
1352.31 |
Total Drug Medicare Standardized Payment Amount |
1352.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
459 |
Number Of Medicare Beneficiaries With Medical Services |
238 |
Total Medical Submitted Charge Amount |
69082 |
Total Medical Medicare Allowed Amount |
36688.38 |
Total Medical Medicare Payment Amount |
21838.98 |
Total Medical Medicare Standardized Payment Amount |
20626.47 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
180 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.0842 |