AVERA ST. MARY'S
NPI: 1124464128
· PIERRE, SD 57501
· Medical Specialty Clinic/Center
· NPI assigned 05/16/2013
$319K
Total Medicaid Paid
Provider Details
| Authorized Official | HOLLAND, MIKEL (CEO/PRESIDENT) |
| Parent Organization | AVERA ST. MARY'S HOSPITAL CHILD ASSESSMENT CENTER |
| NPI Enumeration Date | 05/16/2013 |
Related Entities
Other providers sharing the same authorized official: HOLLAND, MIKEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
208 |
$46K |
| 2019 |
356 |
$41K |
| 2020 |
232 |
$21K |
| 2021 |
360 |
$59K |
| 2022 |
399 |
$63K |
| 2023 |
346 |
$58K |
| 2024 |
167 |
$31K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99499 |
|
955 |
732 |
$173K |
| 99205 |
Prolong outpt/office vis |
851 |
726 |
$96K |
| W8710 |
|
141 |
66 |
$32K |
| W8700 |
|
67 |
42 |
$14K |
| 99170 |
|
54 |
38 |
$5K |