Michele Keesling, NP
Adult Health · Galax, VANPI 1659824332
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 97.1% of the total across 316 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 31 manufacturers, the largest accounting for just 23.7% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,431, 2.2 times the $636 reported in 2021. Among adult health clinicians in VA with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 316 payments — averaging $16.43 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$1K
- Otsuka America Pharmaceutical, Inc.$422
- Novo Nordisk$407
- Currax Pharmaceuticals LLC$337
- AstraZeneca$319
- Vanda Pharmaceuticals Inc.$309
- plus $2K from 25 others
What the payments were for
- Food & beverage$5,04097%
- Education$1513%
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 |
|---|---|---|
| AbbVie | 95 | $1,230 |
| Otsuka America Pharmaceutical, Inc. | 24 | $422 |
| Novo Nordisk | 26 | $407 |
| Currax Pharmaceuticals LLC | 24 | $337 |
| AstraZeneca | 16 | $319 |
| Vanda Pharmaceuticals Inc. | 15 | $309 |
| Axsome Therapeutics, Inc. | 17 | $300 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 13 | $276 |
| Lilly USA, LLC | 11 | $208 |
| Pfizer | 12 | $177 |
| Novartis | 10 | $177 |
| Alkermes, Inc. | 8 | $149 |
| Takeda Pharmaceuticals U.S.A., Inc. | 9 | $138 |
| Pharmacyclics LLC, An Abbvie Company | 3 | $138 |
| Ironshore Pharmaceuticals Inc. | 5 | $94 |
| Xeris Pharmaceuticals, Inc. | 5 | $91 |
| Johnson & Johnson(2 entities) | 4 | $76 |
| Dexcom, Inc. | 2 | $61 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 3 | $49 |
| GSK | 2 | $42 |
| Amarin Pharma, Inc. | 2 | $28 |
| Lundbeck LLC | 1 | $23 |
| Boehringer Ingelheim | 1 | $23 |
| Abbott | 1 | $22 |
| Seagen Inc. | 1 | $14 |
| Exact Sciences | 1 | $14 |
| Amgen | 1 | $14 |
| E.r. Squibb & Sons, L.L.C. | 1 | $14 |
| Astellas Pharma US Inc | 1 | $14 |
| Bayer | 1 | $13 |
| Teva Pharmaceuticals USA, Inc. | 1 | $12 |
How this compares
$5,191 in reported general payments places this provider in the 90th percentile of 368 adult health providers in Virginia.
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 |
|---|---|---|
| OzempicSemaglutide | 61 | $68,939 |
| EliquisApixaban | 101 | $66,266 |
| MounjaroTirzepatide | 46 | $54,891 |
| VraylarCariprazine Hcl | 24 | $35,696 |
| Nurtec OdtRimegepant Sulfate | 13 | $25,139 |
| FarxigaDapagliflozin Propanediol | 31 | $23,873 |
| RexultiBrexpiprazole | 15 | $22,167 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 24 | $21,386 |
| TrulicityDulaglutide | 14 | $20,853 |
| UbrelvyUbrogepant | 14 | $17,590 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 28 | $17,098 |
| QuliptaAtogepant | 11 | $13,534 |
| Breo ElliptaFluticasone/Vilanterol | 17 | $9,991 |
| OxycontinOxycodone Hcl | 12 | $8,162 |
| LinzessLinaclotide | 12 | $7,584 |
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, Nurtec Odt | $177 | $91,406114 claims |
| Lilly USA, LLCMounjaro, Trulicity | $208 | $75,74460 claims |
| AbbVieVraylar, Ubrelvy, Qulipta, Linzess, Synthroid | $1,230 | $75,74375 claims |
| Novo NordiskOzempic | $407 | $68,93961 claims |
| AstraZenecaFarxiga, Breztri Aerosphere, Symbicort | $319 | $47,68277 claims |
| GSKTrelegy Ellipta, Breo Ellipta | $42 | $31,37741 claims |
| Otsuka America Pharmaceutical, Inc.Rexulti | $422 | $22,16715 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Motegrity | $138 | $5,89211 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 90th percentile of 368 adult health providers in Virginia.
Other adult health in Galax
- Christine KesslerFort Belvoir$107K
- Denise BruenCharlottesville$45K
- Theresa Harrington StukusFairfax$40K
- Chelsea KoskovichFredericksburg$34K
- Brittany BrownLynchburg$14K
- Colleen DieringVirginia Beach$13K
- Veronica HughesRichmond$12K
- Nicole SellersNorfolk$12K
- Amy WenzelMechanicsville$11K
- Robert GrossmanDanville$10K
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.