| National Provider Identifier [NPI]: | 1548351893 |
| Last Name Of The Provider | BLOMSTEDT |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1401 E H ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MC COOK |
| Zip Code Of The Provider | 690013589 |
| 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 | 155 |
| Number Of Services | 6765 |
| Number Of Medicare Beneficiaries | 972 |
| Total Submitted Charge Amount | 369867.84 |
| Total Medicare Allowed Amount | 236216.77 |
| Total Medicare Payment Amount | 177589.53 |
| Total Medicare Standardized Payment Amount | 187099.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1546 |
| Number Of Medicare Beneficiaries With Drug Services | 544 |
| Total Drug Submitted ChargeAmount | 27039.37 |
| Total Drug Medicare AllowedAmount | 24107.15 |
| Total Drug Medicare PaymentAmount | 22353.88 |
| Total Drug Medicare Standardized Payment Amount | 22353.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 136 |
| Number Of Medical Services | 5219 |
| Number Of Medicare Beneficiaries With Medical Services | 972 |
| Total Medical Submitted Charge Amount | 342828.47 |
| Total Medical Medicare Allowed Amount | 212109.62 |
| Total Medical Medicare Payment Amount | 155235.65 |
| Total Medical Medicare Standardized Payment Amount | 164745.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 286 |
| Number Of Beneficiaries Age 75 to 84 | 376 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 530 |
| Number Of Male Beneficiaries | 442 |
| Number Of Non Hispanic White Beneficiaries | 948 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 816 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.1271 |