| National Provider Identifier [NPI]: | 1134161227 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5301 HOLLISTER ST |
| Street Address 2 Of The Provider | SUITE 350 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770406100 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 5067 |
| Number Of Medicare Beneficiaries | 3588 |
| Total Submitted Charge Amount | 791335.45 |
| Total Medicare Allowed Amount | 119744.62 |
| Total Medicare Payment Amount | 92138.29 |
| Total Medicare Standardized Payment Amount | 94071.11 |
| 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 | 171 |
| Number Of Medical Services | 5067 |
| Number Of Medicare Beneficiaries With Medical Services | 3588 |
| Total Medical Submitted Charge Amount | 791335.45 |
| Total Medical Medicare Allowed Amount | 119744.62 |
| Total Medical Medicare Payment Amount | 92138.29 |
| Total Medical Medicare Standardized Payment Amount | 94071.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 426 |
| Number Of Beneficiaries Age 65 to 74 | 1480 |
| Number Of Beneficiaries Age 75 to 84 | 1116 |
| Number Of Beneficiaries Age Greater 84 | 566 |
| Number Of Female Beneficiaries | 2222 |
| Number Of Male Beneficiaries | 1366 |
| Number Of Non Hispanic White Beneficiaries | 2576 |
| Number Of Black or African American Beneficiaries | 378 |
| Number Of AsianPacific Islander Beneficiaries | 103 |
| Number Of Hispanic Beneficiaries | 497 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2880 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 708 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4567 |