| National Provider Identifier [NPI]: | 1518999275 |
| Last Name Of The Provider | BIDDULPH |
| First Name Of The Provider | GLEN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2121 N 1700 W |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAYTON |
| Zip Code Of The Provider | 840418803 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 10884 |
| Number Of Medicare Beneficiaries | 857 |
| Total Submitted Charge Amount | 580001.05 |
| Total Medicare Allowed Amount | 381578.4 |
| Total Medicare Payment Amount | 297839.2 |
| Total Medicare Standardized Payment Amount | 309642.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 2727 |
| Number Of Medicare Beneficiaries With Drug Services | 200 |
| Total Drug Submitted ChargeAmount | 48031.05 |
| Total Drug Medicare AllowedAmount | 38585.99 |
| Total Drug Medicare PaymentAmount | 30962.93 |
| Total Drug Medicare Standardized Payment Amount | 30962.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 8157 |
| Number Of Medicare Beneficiaries With Medical Services | 857 |
| Total Medical Submitted Charge Amount | 531970 |
| Total Medical Medicare Allowed Amount | 342992.41 |
| Total Medical Medicare Payment Amount | 266876.27 |
| Total Medical Medicare Standardized Payment Amount | 278679.29 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 302 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 325 |
| Number Of Non Hispanic White Beneficiaries | 815 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 792 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.231 |