Rebecca Joan Kouma, PA

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.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

• Butler County Health Hospital · David City, NE · listed as Butler County Health Care Center
• Columbus Community Hospital, Inc Hospital · Columbus, NE · listed as Columbus Community Hospital Inc
• The Nebraska Medical Center Hospital · Omaha, NE

Colleagues at Butler County Clinic P C

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 7 clinicians in the practice; 5 are shown here.

• Sidra Akhter, MD Family Medicine Physician · Lincoln, NE
• Mark Vaughn Carlson, MD Family Medicine Physician · David City, NE
• Dr. Robert Austin Daro, MD Family Medicine Physician · David City, NE
• Matthew Paul Summers, MD Family Medicine Physician · David City, NE
• Joshua Sypal, MD Family Medicine Physician · David City, NE

Other providers in David City

• James D Witter Jr., PA-C

  Individual Physician Assistant · NPI 1861421174

  358 S 10th St, David City, NE 68632-2145 · (402) 367-3322