Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Dakota only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Dakota (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Avera Mckennan (NPI 1083972160)

Avera Mckennan is a hospitalist physician provider located in Sioux Falls, South Dakota. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Avera Mckennan
Address	1325 S Cliff Ave
City	Sioux Falls
State	SD
ZIP	57105
Taxonomy	Hospitalist Physician
NPI Enumerated	April 26, 2012

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	26,900	$30	$887.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	13,930	$50	$668.7K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,110	$90	$357.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	4,140	$50	$207.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,820	$60	$180.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2,780	$40	$99.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,540	$20	$53.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	8,960	$10	$44.8K
99219	N/A	540	$50	$26K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	160	$110	$17.7K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Dakota Distribution

Avera Mckennan — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	5	10	240	$140	$472K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4	70	400	$40	$172.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4	40	250	$50	$151.7K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5	40	160	$90	$116.9K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	4	30	180	$60	$83.1K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4	50	200	$70	$50.2K
99220	N/A	2	10	80	$80	$49.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	4	50	180	$50	$49.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	5	50	130	$20	$23.4K
99225	N/A	4	10	220	$30	$14.6K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Dakota Achieve	SD	Developmental Disabilities Clinic/Center	$0	$166.9M
Dakotabilities	SD	Voluntary or Charitable Agency	$0	$77.8M
Volunteers Of America, Dakotas	SD	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$60.9M
Southeastern Behavioral Healthcare	SD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$59.1M
Resouces For Human Development, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$31.1M
Sanford Medical Center	SD	General Acute Care Hospital	$0	$24.4M
Childrens Dental Center	SD	Pediatric Dentistry	$0	$24M
Sanford Medical Center	SD	Air Ambulance	$0	$11.9M
Sanford Clinic	SD	Pediatrics Physician	$0	$5.5M
Lutheran Social Services Of South Dakota Inc	SD	Voluntary or Charitable Agency	$0	$3.6M

Avera Mckennan — Billing Profile & Reimbursement Data

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Avera Mckennan — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Avera Mckennan	SD	Family Medicine Physician	$0	$10.6M
Avera Mckennan	SD	Psychiatry Physician	$0	$9.1M
Avera Mckennan	SD	Home Infusion Agency	$0	$6.7M
Avera Mckennan	SD	Air Ambulance	$0	$5.3M
Avera St Marys	SD	Multi-Specialty Clinic/Center	$0	$4.6M
Avera Mckennan	SD	Emergency Medicine Physician	$0	$4.1M
Avera Mckennan	SD	General Acute Care Hospital	$0	$3.7M
Avera Mckennan	SD	Diagnostic Radiology Physician	$0	$3.3M