| National Provider Identifier [NPI]: | 1215966858 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | EDISON |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1572 S BELL SCHOOL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHERRY VALLEY |
| Zip Code Of The Provider | 610169362 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 6086 |
| Number Of Medicare Beneficiaries | 549 |
| Total Submitted Charge Amount | 585485 |
| Total Medicare Allowed Amount | 252023.52 |
| Total Medicare Payment Amount | 180226.27 |
| Total Medicare Standardized Payment Amount | 188764.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 1725 |
| Number Of Medicare Beneficiaries With Drug Services | 296 |
| Total Drug Submitted ChargeAmount | 69737 |
| Total Drug Medicare AllowedAmount | 20719.89 |
| Total Drug Medicare PaymentAmount | 18085.34 |
| Total Drug Medicare Standardized Payment Amount | 18085.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 4361 |
| Number Of Medicare Beneficiaries With Medical Services | 549 |
| Total Medical Submitted Charge Amount | 515748 |
| Total Medical Medicare Allowed Amount | 231303.63 |
| Total Medical Medicare Payment Amount | 162140.93 |
| Total Medical Medicare Standardized Payment Amount | 170678.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 216 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 299 |
| Number Of Male Beneficiaries | 250 |
| Number Of Non Hispanic White Beneficiaries | 483 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 463 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0665 |