| National Provider Identifier [NPI]: | 1588647499 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 RYAN ST |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | LAKE CHARLES |
| Zip Code Of The Provider | 706016078 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 197 |
| Number Of Services | 14841 |
| Number Of Medicare Beneficiaries | 4474 |
| Total Submitted Charge Amount | 1452477 |
| Total Medicare Allowed Amount | 287206.24 |
| Total Medicare Payment Amount | 219543.23 |
| Total Medicare Standardized Payment Amount | 235045.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7340 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 84545 |
| Total Drug Medicare AllowedAmount | 3487.5 |
| Total Drug Medicare PaymentAmount | 2701.95 |
| Total Drug Medicare Standardized Payment Amount | 2701.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 7501 |
| Number Of Medicare Beneficiaries With Medical Services | 4473 |
| Total Medical Submitted Charge Amount | 1367932 |
| Total Medical Medicare Allowed Amount | 283718.74 |
| Total Medical Medicare Payment Amount | 216841.28 |
| Total Medical Medicare Standardized Payment Amount | 232343.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 954 |
| Number Of Beneficiaries Age 65 to 74 | 1757 |
| Number Of Beneficiaries Age 75 to 84 | 1279 |
| Number Of Beneficiaries Age Greater 84 | 484 |
| Number Of Female Beneficiaries | 2881 |
| Number Of Male Beneficiaries | 1593 |
| Number Of Non Hispanic White Beneficiaries | 3530 |
| Number Of Black or African American Beneficiaries | 849 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1279 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5262 |