| National Provider Identifier [NPI]: | 1437168713 |
| Last Name Of The Provider | KNICELY |
| First Name Of The Provider | MELODIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8434 N SAGINAW RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT MORRIS |
| Zip Code Of The Provider | 484581190 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1531 |
| Number Of Medicare Beneficiaries | 501 |
| Total Submitted Charge Amount | 214590 |
| Total Medicare Allowed Amount | 136887.23 |
| Total Medicare Payment Amount | 107068.35 |
| Total Medicare Standardized Payment Amount | 109486.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1531 |
| Number Of Medicare Beneficiaries With Medical Services | 501 |
| Total Medical Submitted Charge Amount | 214590 |
| Total Medical Medicare Allowed Amount | 136887.23 |
| Total Medical Medicare Payment Amount | 107068.35 |
| Total Medical Medicare Standardized Payment Amount | 109486.85 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 142 |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 296 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 386 |
| Number Of Black or African American Beneficiaries | 88 |
| 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 | 309 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 192 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.6173 |