| National Provider Identifier [NPI]: | 1124028733 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5575 W LAS POSITAS BLVD |
| Street Address 2 Of The Provider | # 130 |
| City Of The Provider | PLEASANTON |
| Zip Code Of The Provider | 945885801 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 529 |
| Number Of Medicare Beneficiaries | 77 |
| Total Submitted Charge Amount | 58927 |
| Total Medicare Allowed Amount | 26722.99 |
| Total Medicare Payment Amount | 17521.24 |
| Total Medicare Standardized Payment Amount | 15747.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 254 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 5813 |
| Total Drug Medicare AllowedAmount | 3638.48 |
| Total Drug Medicare PaymentAmount | 2883.49 |
| Total Drug Medicare Standardized Payment Amount | 2883.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 275 |
| Number Of Medicare Beneficiaries With Medical Services | 77 |
| Total Medical Submitted Charge Amount | 53114 |
| Total Medical Medicare Allowed Amount | 23084.51 |
| Total Medical Medicare Payment Amount | 14637.75 |
| Total Medical Medicare Standardized Payment Amount | 12863.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8447 |