| National Provider Identifier [NPI]: | 1447290598 |
| Last Name Of The Provider | HEBDON |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5444 GREEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MURRAY |
| Zip Code Of The Provider | 841235632 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 8650 |
| Number Of Medicare Beneficiaries | 1836 |
| Total Submitted Charge Amount | 1069252.99 |
| Total Medicare Allowed Amount | 237791.27 |
| Total Medicare Payment Amount | 179217.48 |
| Total Medicare Standardized Payment Amount | 195308.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 6159 |
| Number Of Medicare Beneficiaries With Drug Services | 148 |
| Total Drug Submitted ChargeAmount | 14247.72 |
| Total Drug Medicare AllowedAmount | 2445.88 |
| Total Drug Medicare PaymentAmount | 1871.18 |
| Total Drug Medicare Standardized Payment Amount | 1871.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 187 |
| Number Of Medical Services | 2491 |
| Number Of Medicare Beneficiaries With Medical Services | 1836 |
| Total Medical Submitted Charge Amount | 1055005.27 |
| Total Medical Medicare Allowed Amount | 235345.39 |
| Total Medical Medicare Payment Amount | 177346.3 |
| Total Medical Medicare Standardized Payment Amount | 193437.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 295 |
| Number Of Beneficiaries Age 65 to 74 | 679 |
| Number Of Beneficiaries Age 75 to 84 | 626 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 999 |
| Number Of Male Beneficiaries | 837 |
| Number Of Non Hispanic White Beneficiaries | 1633 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 45 |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1537 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 299 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.746 |