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 1710316252)

Field	Value
Entity Type	Organization
Organization	Avera Mckennan
Address	4210 W 53rd St
City	Sioux Falls
State	SD
ZIP	57106
Taxonomy	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
NPI Enumerated	November 5, 2013

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	112,760	$10	$1M
J1644	Injection, heparin sodium, per 1000 units	16,970	$1	$17K
J2501	Injection, paricalcitol, 1 mcg	13,080	$1	$13.1K
A9270	Non-covered item or service	4,620	$1	$9.2K
J3490	Unclassified drugs	330	$20	$5.3K
82040	The lab analyst performs a quantitative measurement on a serum, plasma, or whole blood specimen for albumin.	10	$0	$0
82310	The lab analyst measures the calcium level, primarily on a serum sample.	10	$0	$0
82374	The lab analyst measures the carbon dioxide, primarily in serum. Most of the carbon dioxide in blood exists as bicarbonate with much of the balance as carbonic acid.	10	$0	$0
82565	The lab analyst measures the amount of creatinine in a patient specimen, typically of blood. Creatinine is the waste material generated by the muscle tissue produced from the breakdown of creatine…	10	$0	$0
84100	The lab analyst performs a test to evaluate the level of phosphate, which is phosphorus not contained in biological compounds, in a patient specimen such as serum.	30	$0	$0

Showing 1–10 of 20

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 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3490	Unclassified drugs	20	20	1,200	$170	$1M
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	2	30	3,520	$50	$769.4K
A9270	Non-covered item or service	6	30	1,140	$20	$80.5K
J0882	Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)	1	10	680	$60	$75.7K
J2916	Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg	3	10	170	$50	$8.3K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	18	20	90	$10	$6.2K
84100	The lab analyst performs a test to evaluate the level of phosphate, which is phosphorus not contained in biological compounds, in a patient specimen such as serum.	5	10	730	$1	$5.8K
J1756	Injection, iron sucrose, 1 mg	2	10	2,390	$1	$5.6K
84460	The lab analyst performs the technical lab test, typically using serum or plasma, to quantitate the enzyme alanine amino transferase, or ALT, also called SGPT, serum glutamate pyruvate transaminase.…	5	10	310	$1	$4.3K
J2501	Injection, paricalcitol, 1 mcg	2	10	7,430	$1	$4K

Showing 1–10 of 20

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
Universal Nursing Services, Ltd	SD	Home Health Agency	$0	$33.2M
Independent Living Choices	SD	Home Health Agency	$0	$13M
Edgewood Prairie Crossings Sioux Falls	SD	Assisted Living Facility	$0	$1.8M
Children's Care Hospital And School	SD	Rehabilitation Hospital	$0	$1.8M
Kore Cares, LLC	SD	Home Health Agency	$0	$1.3M
Weber Home Care Services LLC	SD	Home Health Agency	$0	$1.3M
Stronghold Counseling Services Inc	SD	Counselor	$0	$1.1M
Gpps LLC	SD	Multi-Specialty Clinic/Center	$0	$836.4K
North Central Eye, Inc.	SD	Clinic/Center	$0	$764.5K
Insight Eye Care Professionals, P.C.	SD	Optometrist	$0	$638.4K

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