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 1558427187)

Field	Value
Entity Type	Organization
Organization	Avera Mckennan
Address	1325 S Cliff Ave
City	Sioux Falls
State	SD
ZIP	57105
Taxonomy	Air Ambulance
NPI Enumerated	December 28, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

Key Findings

Provider business profile is consistent with an air-ambulance operator: taxonomy is Air Ambulance and Medicaid billing is concentrated in transport and mileage codes for fixed-wing and rotary-wing services (A0430, A0435, A0431, A0436). Claim volumes support this operational profile—A0430 shows 1.9K claims, A0435 2.1K claims, A0431 526 claims, and A0436 585 claims—indicating routine, mission-driven air transports rather than sporadic ground-service activity.

Medicaid revenue is highly concentrated: the precomputed top-3 Medicaid codes (A0430, A0435, A0431) account for 93.6% of the provider's total Medicaid revenue. The single largest revenue driver is A0430 (45.7% of Medicaid revenue), followed by A0435 (34.2%) and A0431 (13.7%), which indicates the business depends on a narrow set of air-transport services for nearly all Medicaid receipts.

This provider is effectively single-payer from the available data: there is no Medicare billing on file while total Medicaid revenue is $5.3M. The absence of Medicare revenue means the provider’s public-payer exposure and reimbursement sensitivity will be concentrated in Medicaid policy, rates, and network participation in South Dakota.

Competitive standing within the state appears modest rather than dominant. For its largest codes A0430 and A0435 the provider ranks #3 of 7 in-state (67th percentile) and volumes are labeled "typical, unremarkable volume for this code," while A0431 and A0436 rank #2 of 3 (50th percentile); these positions suggest it is an established peer but not a statewide leader.

Average-paid-per-claim levels show relative unit-value differences across services: A0430 average paid/claim is $1315, A0435 is $888, A0431 is $1395, and A0436 is $582. The higher averages for A0430 and A0431 (conventional air services) versus the mileage codes imply that base transport fees constitute a substantial portion of revenue per trip compared with per-mile reimbursements.

The provider’s Medicaid claim counts and payment amounts reflect sustained operational throughput rather than sporadic billing spikes—e.g., thousands of claims for the top fixed-wing codes (1.9K and 2.1K) and consistent per-claim payments. Combined with the NPI being enumerated on 2006-12-28 (~20 years ago), this pattern indicates a long-tenured, steady air-transport operation in Sioux Falls rather than a newly established entrant.

Statistically, the dataset flags these code volumes as within expected ranges: all cited codes are described as "typical, unremarkable volume for this code" rather than outliers. Analysts should therefore interpret this provider as a stable, mid-tier in-state air-ambulance participant with concentrated Medicaid revenue exposure rather than an anomalous high-variance filer.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	1,860	$1,320	$2.4M
A0435	Fixed wing air mileage, per statute mile	2,050	$890	$1.8M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	530	$1,400	$733.8K
A0436	Rotary wing air mileage, per statute mile	590	$580	$340.5K

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 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	3	10	1,130	$1,520	$2.2M
A0435	Fixed wing air mileage, per statute mile	3	10	1,160	$1,280	$1.9M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	2	10	530	$1,770	$1.1M
A0436	Rotary wing air mileage, per statute mile	2	10	590	$800	$503.2K

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 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
Avera Mckennan	SD	Hospitalist Physician	$0	$2.6M

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
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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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References