| National Provider Identifier [NPI]: | 1093700494 |
| Last Name Of The Provider | ETHERIDGE |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.P.M |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6160 N DAVIS HWY |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | PENSACOLA |
| Zip Code Of The Provider | 325046994 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 8697 |
| Number Of Medicare Beneficiaries | 1173 |
| Total Submitted Charge Amount | 779681.74 |
| Total Medicare Allowed Amount | 473992.03 |
| Total Medicare Payment Amount | 351057.44 |
| Total Medicare Standardized Payment Amount | 352840.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1242 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 15969.12 |
| Total Drug Medicare AllowedAmount | 7222.95 |
| Total Drug Medicare PaymentAmount | 5542.31 |
| Total Drug Medicare Standardized Payment Amount | 5542.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 7455 |
| Number Of Medicare Beneficiaries With Medical Services | 1173 |
| Total Medical Submitted Charge Amount | 763712.62 |
| Total Medical Medicare Allowed Amount | 466769.08 |
| Total Medical Medicare Payment Amount | 345515.13 |
| Total Medical Medicare Standardized Payment Amount | 347297.83 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 375 |
| Number Of Beneficiaries Age 75 to 84 | 425 |
| Number Of Beneficiaries Age Greater 84 | 259 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 534 |
| Number Of Non Hispanic White Beneficiaries | 1010 |
| Number Of Black or African American Beneficiaries | 137 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1034 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7957 |