| National Provider Identifier [NPI]: | 1548339898 |
| Last Name Of The Provider | LIM |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3145 DIXIE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERFORD |
| Zip Code Of The Provider | 483281602 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 5815 |
| Number Of Medicare Beneficiaries | 801 |
| Total Submitted Charge Amount | 741302 |
| Total Medicare Allowed Amount | 360251.08 |
| Total Medicare Payment Amount | 266745.37 |
| Total Medicare Standardized Payment Amount | 262056.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1730 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 107700 |
| Total Drug Medicare AllowedAmount | 27846.23 |
| Total Drug Medicare PaymentAmount | 21683.86 |
| Total Drug Medicare Standardized Payment Amount | 21683.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 4085 |
| Number Of Medicare Beneficiaries With Medical Services | 801 |
| Total Medical Submitted Charge Amount | 633602 |
| Total Medical Medicare Allowed Amount | 332404.85 |
| Total Medical Medicare Payment Amount | 245061.51 |
| Total Medical Medicare Standardized Payment Amount | 240373.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 352 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 640 |
| Number Of Non Hispanic White Beneficiaries | 670 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 665 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.502 |