Robert Gianfagna, MD
Cardiovascular Disease · Buffalo, NYNPI 1386650943
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.0% of the total across 493 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 33 manufacturers, the largest accounting for just 15.7% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2019 at $2,513 and has fallen 97.5% since, to $63 in 2025.
Across 493 payments — averaging $18.04 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$1K
- Boehringer Ingelheim$939
- Pfizer$841
- Actelion Pharmaceuticals US, Inc.$722
- Novartis$695
- E.r. Squibb & Sons, L.L.C.$583
- plus $4K from 27 others
Across 25 payments — averaging $7693.94 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Amgen$155K
- Novartis$19K
- ZOLL Services LLC (a/k/a ZOLL Lifecor Corp)$11K
- Abbott$7K
What the payments were for
- Food & beverage$8,80199%
- Education$931%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Amgen | 94 | $1,393 |
| Boehringer Ingelheim | 40 | $939 |
| Pfizer | 48 | $841 |
| Actelion Pharmaceuticals US, Inc. | 21 | $722 |
| Novartis | 43 | $695 |
| E.r. Squibb & Sons, L.L.C. | 34 | $583 |
| Johnson & Johnson | 47 | $508 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 23 | $425 |
| Bayer | 21 | $378 |
| Merck | 17 | $315 |
| Boston Scientific | 10 | $312 |
| Amarin Pharma, Inc. | 13 | $286 |
| Edwards Lifesciences | 10 | $209 |
| Biotronik Inc. | 6 | $161 |
| Sanofi-aventis U.S. LLC | 9 | $132 |
| Gilead | 9 | $131 |
| Vifor Pharma, Inc. | 6 | $125 |
| Scpharmaceuticals Inc. | 7 | $121 |
| AstraZeneca | 7 | $107 |
| Impulse Dynamics (USA) Inc. | 4 | $100 |
| Novo Nordisk | 6 | $100 |
| Alnylam Pharmaceuticals Inc. | 3 | $52 |
| Lexicon Pharmaceuticals, Inc. | 3 | $47 |
| Medtronic(2 entities) | 2 | $29 |
| Abiomed | 1 | $26 |
| Kiniksa Pharmaceuticals, Ltd. | 2 | $26 |
| Daiichi Sankyo Inc. | 1 | $25 |
| Abbott | 1 | $21 |
| Akcea Therapeutics, Inc. | 1 | $18 |
| Kestra Medical Technology Services, Inc. | 1 | $18 |
| Astellas Pharma US Inc | 1 | $18 |
| Amryt Pharma Holdings Ltd | 1 | $17 |
| Inogen, Inc. | 1 | $14 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
How this compares
$8,895 in reported general payments places this provider in the 80th percentile of 2,302 cardiovascular disease providers in New York.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| EliquisApixaban | 317 | $315,081 |
| EntrestoSacubitril/Valsartan | 65 | $80,636 |
| Repatha SureclickEvolocumab | 70 | $79,494 |
| XareltoRivaroxaban | 56 | $69,117 |
| JardianceEmpagliflozin | 45 | $43,061 |
| BrilintaTicagrelor | 42 | $36,456 |
| Dabigatran EtexilateDabigatran Etexilate Mesylate | 34 | $10,934 |
| Ranolazine ErRanolazine | 144 | $9,364 |
| Metoprolol Succinate | 418 | $8,017 |
| Atorvastatin Calcium | 294 | $5,238 |
| Rosuvastatin Calcium | 159 | $2,984 |
| ClopidogrelClopidogrel Bisulfate | 151 | $2,838 |
| Irbesartan | 109 | $2,628 |
| Lisinopril | 203 | $2,580 |
| Dofetilide | 17 | $2,015 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| PfizerEliquis | $841 | $315,081317 claims |
| NovartisEntresto | $695 | $80,63665 claims |
| Johnson & JohnsonXarelto | $508 | $69,11756 claims |
| Boehringer IngelheimJardiance | $939 | $43,06145 claims |
| AstraZenecaBrilinta | $107 | $36,45642 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 80th percentile of 2,302 cardiovascular disease providers in New York.
Other cardiovascular disease in Buffalo
- Saurabh MalhotraBuffalo$438K
- Roger HajjarNew York$5.2M
- Szilard VorosStony Brook$3.7M
- Gregg StoneNew York$2M
- Augustin DelagoAlbany$1.8M
- Philippe GenereuxNew York$1.3M
- Adam RosenbluthNew York$1.1M
- Luigi di BiaseBronx$978K
- Vijay IyerAmherst$855K
- Megha PrasadNew York$813K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.