| National Provider Identifier [NPI]: | 1053345686 |
| Last Name Of The Provider | PAYSEN |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3907 6TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KEARNEY |
| Zip Code Of The Provider | 688453392 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 2060 |
| Number Of Medicare Beneficiaries | 190 |
| Total Submitted Charge Amount | 107539 |
| Total Medicare Allowed Amount | 62070.84 |
| Total Medicare Payment Amount | 49670.19 |
| Total Medicare Standardized Payment Amount | 52822.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 569 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 12225 |
| Total Drug Medicare AllowedAmount | 9839.71 |
| Total Drug Medicare PaymentAmount | 8241.35 |
| Total Drug Medicare Standardized Payment Amount | 8241.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 1491 |
| Number Of Medicare Beneficiaries With Medical Services | 190 |
| Total Medical Submitted Charge Amount | 95314 |
| Total Medical Medicare Allowed Amount | 52231.13 |
| Total Medical Medicare Payment Amount | 41428.84 |
| Total Medical Medicare Standardized Payment Amount | 44580.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 46 |
| 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 | 158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1263 |