| National Provider Identifier [NPI]: | 1447286265 |
| Last Name Of The Provider | KNISELY |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 514 ADAMS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RADFORD |
| Zip Code Of The Provider | 241426899 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 346 |
| Number Of Medicare Beneficiaries | 130 |
| Total Submitted Charge Amount | 31296 |
| Total Medicare Allowed Amount | 19403.04 |
| Total Medicare Payment Amount | 13114.85 |
| Total Medicare Standardized Payment Amount | 14182.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 837 |
| Total Drug Medicare AllowedAmount | 502.67 |
| Total Drug Medicare PaymentAmount | 487.28 |
| Total Drug Medicare Standardized Payment Amount | 487.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 314 |
| Number Of Medicare Beneficiaries With Medical Services | 127 |
| Total Medical Submitted Charge Amount | 30459 |
| Total Medical Medicare Allowed Amount | 18900.37 |
| Total Medical Medicare Payment Amount | 12627.57 |
| Total Medical Medicare Standardized Payment Amount | 13695.08 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0185 |