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 1396945267)

Field	Value
Entity Type	Organization
Organization	Avera Mckennan
Address	1600 S Highline Ave Ste 220
City	Sioux Falls
State	SD
ZIP	57110
Taxonomy	Hepatology Physician
NPI Enumerated	July 19, 2007

Payer Source	Total Paid
Medicaid	$54.2K
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	670	$40	$28.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	340	$30	$10.6K
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…	120	$60	$6.9K
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…	160	$40	$6.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$70	$1.2K

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 — 0 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	221	340	1,010	$100	$511K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	142	260	860	$80	$222.6K
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…	47	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…	27	40	250	$50	$151.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	69	70	130	$100	$99K

Nearby Providers

Other providers in the same ZIP code as Avera Mckennan, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Home Society Of South Dakota	SD	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$62.7M
Meadows On Sycamore Inc	SD	Assisted Living Facility	$0	$8.2M
Lisa Hemmingson	SD	Mental Health Counselor	$0	$655.6K
Dr. John W Sivesind, O.d., P.C.	SD	Corneal and Contact Management Optometrist	$0	$520.2K
Bonnie Deen	SD	Mental Health Counselor	$0	$415.7K
Hy-vee Inc	SD	Community/Retail Pharmacy	$245.9K	$0
Avera Mckennan	SD	Endocrinology, Diabetes & Metabolism Physician	$0	$155.1K
Precision Vision, Inc	SD	Eyewear Supplier	$0	$150K
Best Life, LLC	SD	Professional Counselor	$0	$133.5K
Jallah Kpanquoi	SD	In Home Supportive Care Agency	$0	$131.6K

Avera Mckennan — Billing Profile & Reimbursement Data

Sign up for Avera Mckennan — Billing Profile & Reimbursement Data policy alerts

Avera Mckennan — Billing Profile & Reimbursement Data

Sign up for Avera Mckennan — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References