| National Provider Identifier [NPI]: | 1013979285 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | JAIME |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1722 9TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763015003 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 8227 |
| Number Of Medicare Beneficiaries | 454 |
| Total Submitted Charge Amount | 2099090 |
| Total Medicare Allowed Amount | 1067083.05 |
| Total Medicare Payment Amount | 821983.89 |
| Total Medicare Standardized Payment Amount | 849357.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1620 |
| Number Of Medicare Beneficiaries With Drug Services | 273 |
| Total Drug Submitted ChargeAmount | 28481 |
| Total Drug Medicare AllowedAmount | 3124.83 |
| Total Drug Medicare PaymentAmount | 2436.47 |
| Total Drug Medicare Standardized Payment Amount | 2436.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 6607 |
| Number Of Medicare Beneficiaries With Medical Services | 454 |
| Total Medical Submitted Charge Amount | 2070609 |
| Total Medical Medicare Allowed Amount | 1063958.22 |
| Total Medical Medicare Payment Amount | 819547.42 |
| Total Medical Medicare Standardized Payment Amount | 846921.36 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 292 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | 356 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 266 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5547 |