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 1427090760)

Field	Value
Entity Type	Organization
Organization	Avera Mckennan
Address	110 S Logan Ave Ste A
City	Gregory
State	SD
ZIP	57533
Taxonomy	Clinic/Center
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicaid	$400.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	6,640	$40	$272.1K
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…	770	$70	$57K
W0037	N/A	1,800	$20	$37.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	150	$70	$9.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	800	$10	$8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	200	$20	$3.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	900	$1	$3.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	$70	$2.8K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	50	$50	$2.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	160	$10	$1.1K

Showing 1–10 of 18

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 16 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

18 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…	58	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…	136	260	860	$80	$222.6K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	56	70	1,150	$50	$155.9K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	44	50	410	$80	$127.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	149	160	210	$120	$97.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	56	110	990	$20	$82.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	49	60	170	$90	$66.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	50	160	180	$40	$59.6K
W0037	N/A	56	160	690	$20	$50.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	30	70	110	$110	$42.9K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Avera Mckennan, ranked by combined Medicare and Medicaid revenue.

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

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
Hull Dental Health, PC	SD	General Practice Dentistry	$0	$126.2K
Lincare Inc.	SD	Durable Medical Equipment & Medical Supplies	$0	$82.5K
Avera Mckennan	SD	Critical Access Hospital	$0	$78.6K
City Of Gregory	SD	Land Ambulance	$74.8K	$0
Healing Hands, LLC	SD	Chiropractor	$0	$47.6K
Blair Sedlacek	SD	Social Worker	$27.9K	$0
Melissa Bartling	SD	Family Medicine Physician	$10.5K	$0

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