| National Provider Identifier [NPI]: | 1821290644 |
| Last Name Of The Provider | ETHIER |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATTLEBORO |
| Zip Code Of The Provider | 027033143 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 5134 |
| Number Of Medicare Beneficiaries | 2815 |
| Total Submitted Charge Amount | 601204 |
| Total Medicare Allowed Amount | 154174.77 |
| Total Medicare Payment Amount | 119516.27 |
| Total Medicare Standardized Payment Amount | 118996.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 5134 |
| Number Of Medicare Beneficiaries With Medical Services | 2815 |
| Total Medical Submitted Charge Amount | 601204 |
| Total Medical Medicare Allowed Amount | 154174.77 |
| Total Medical Medicare Payment Amount | 119516.27 |
| Total Medical Medicare Standardized Payment Amount | 118996.56 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 617 |
| Number Of Beneficiaries Age 65 to 74 | 993 |
| Number Of Beneficiaries Age 75 to 84 | 796 |
| Number Of Beneficiaries Age Greater 84 | 409 |
| Number Of Female Beneficiaries | 1902 |
| Number Of Male Beneficiaries | 913 |
| Number Of Non Hispanic White Beneficiaries | 2657 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1866 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 949 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3682 |