| National Provider Identifier [NPI]: | 1417080763 |
| Last Name Of The Provider | MIGGIANI |
| First Name Of The Provider | WOLFGANG |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 70 BAXTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRASHER FALLS |
| Zip Code Of The Provider | 136134110 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 16429 |
| Number Of Medicare Beneficiaries | 393 |
| Total Submitted Charge Amount | 432956.82 |
| Total Medicare Allowed Amount | 145593.44 |
| Total Medicare Payment Amount | 110205.92 |
| Total Medicare Standardized Payment Amount | 112015.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 47 |
| Number Of Drug Services | 15337 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 264527.82 |
| Total Drug Medicare AllowedAmount | 87432.18 |
| Total Drug Medicare PaymentAmount | 67869.55 |
| Total Drug Medicare Standardized Payment Amount | 67869.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 1092 |
| Number Of Medicare Beneficiaries With Medical Services | 393 |
| Total Medical Submitted Charge Amount | 168429 |
| Total Medical Medicare Allowed Amount | 58161.26 |
| Total Medical Medicare Payment Amount | 42336.37 |
| Total Medical Medicare Standardized Payment Amount | 44146.2 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 135 |
| Number Of Non Hispanic White Beneficiaries | 373 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 293 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2153 |