| National Provider Identifier [NPI]: | 1780649939 |
| Last Name Of The Provider | WIGGERS |
| First Name Of The Provider | MARCEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 495 RAMSEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRANTS PASS |
| Zip Code Of The Provider | 975275681 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 4743 |
| Number Of Medicare Beneficiaries | 374 |
| Total Submitted Charge Amount | 410065.5 |
| Total Medicare Allowed Amount | 163018.67 |
| Total Medicare Payment Amount | 126396.94 |
| Total Medicare Standardized Payment Amount | 130712.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 350 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 7460.25 |
| Total Drug Medicare AllowedAmount | 5743.74 |
| Total Drug Medicare PaymentAmount | 5453.98 |
| Total Drug Medicare Standardized Payment Amount | 5453.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 4393 |
| Number Of Medicare Beneficiaries With Medical Services | 373 |
| Total Medical Submitted Charge Amount | 402605.25 |
| Total Medical Medicare Allowed Amount | 157274.93 |
| Total Medical Medicare Payment Amount | 120942.96 |
| Total Medical Medicare Standardized Payment Amount | 125258.54 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 178 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 173 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 361 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9465 |