Mrs. Bianca Nicole Caswell, FNP-C

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Colleagues at Alegent Creighton Clinic

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 947 clinicians in the practice; 12 are shown here.

• Rebecca A Andresen, RN Registered Nurse · Omaha, NE
• Carolyn Bevins Family Nurse Practitioner · Omaha, NE
• Nicholas David Christensen, APRN Nurse Practitioner · Omaha, NE
• Dr. Farzad Effan, MBBS Family Medicine Physician · Omaha, NE
• Dr. Steven G. Lapke, MD Family Medicine Physician · Columbus, NE
• Dr. Adam Gene Macdissi, MD Internal Medicine Physician · Omaha, NE
• Summer Ann Malina, PA-C Physician Assistant · Lincoln, NE
• Alyna Nguyen Student in an Organized Health Care Education/Training Program · Omaha, NE
• Nicole E Peterson, APRN Family Nurse Practitioner · Omaha, NE
• Brindi Pinkelman, APRN Women's Health Nurse Practitioner · Omaha, NE
• Amandeep Kaur Rakhra, DO Internal Medicine Physician · Omaha, NE
• Paul Robert Synowicki, MD Family Medicine Physician · Saint Cloud, FL