| National Provider Identifier [NPI]: | 1144212366 |
| Last Name Of The Provider | ETHERTON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 106 MILFORD ST |
| Street Address 2 Of The Provider | SUITE 605 |
| City Of The Provider | SALISBURY |
| Zip Code Of The Provider | 218046953 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 12229 |
| Number Of Medicare Beneficiaries | 3553 |
| Total Submitted Charge Amount | 1416302 |
| Total Medicare Allowed Amount | 909973.02 |
| Total Medicare Payment Amount | 677605.76 |
| Total Medicare Standardized Payment Amount | 668656.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 794 |
| Number Of Medicare Beneficiaries With Drug Services | 199 |
| Total Drug Submitted ChargeAmount | 49026.8 |
| Total Drug Medicare AllowedAmount | 42048.46 |
| Total Drug Medicare PaymentAmount | 32700.71 |
| Total Drug Medicare Standardized Payment Amount | 32700.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 11435 |
| Number Of Medicare Beneficiaries With Medical Services | 3553 |
| Total Medical Submitted Charge Amount | 1367275.2 |
| Total Medical Medicare Allowed Amount | 867924.56 |
| Total Medical Medicare Payment Amount | 644905.05 |
| Total Medical Medicare Standardized Payment Amount | 635955.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 307 |
| Number Of Beneficiaries Age 65 to 74 | 1331 |
| Number Of Beneficiaries Age 75 to 84 | 1337 |
| Number Of Beneficiaries Age Greater 84 | 578 |
| Number Of Female Beneficiaries | 1689 |
| Number Of Male Beneficiaries | 1864 |
| Number Of Non Hispanic White Beneficiaries | 3117 |
| Number Of Black or African American Beneficiaries | 377 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3069 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 484 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5893 |