Avera Mckennan
Avera Mckennan was paid $445K by Medicaid between Jan 2018 and Dec 2024, across 13 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 42% of everything it billed.
SIOUX FALLS, SD 57108
Next to other Gastroenterology Physician providers in South Dakota
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 568 | $30K | |
| 2019 | 562 | $36K | |
| 2020 | 634 | $37K | |
| 2021 | 890 | $57K | |
| 2022 | 941 | $71K | |
| 2023 | 834 | $70K | |
| 2024incomplete | 1,135 | $143K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 42% | 1,456 | 1,239 | $186K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 17% | 443 | 352 | $74K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 14% | 1,509 | 1,383 | $62K |
| 43235 | 5.1% | 129 | 121 | $23K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 4.1% | 592 | 329 | $18K |
| 99221 | 3.8% | 362 | 318 | $17K | |
| 99222 | Initial hospital care, per day, moderate complexity | 3.7% | 199 | 162 | $16K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.9% | 618 | 572 | $13K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 2.6% | 32 | 30 | $11K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.2% | 105 | 92 | $10K |
| 99223 | Prolong inpt eval add15 m | 2.1% | 94 | 86 | $9K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 13 | 12 | $4K |
1 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 12 | $794.23 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Avera Mckennan | Sioux Falls, SD | $9.09M |
| Avera Mckennan | Sioux Falls, SD | $2.56M |
| Avera Mckennan | Sioux Falls, SD | $2.34M |
| Avera Mckennan | Sioux Falls, SD | $2.04M |
| Avera Mckennan | Sioux Falls, SD | $1.86M |
| Avera Mckennan | Sioux Falls, SD | $1.80M |
| Avera Mckennan | Sioux Falls, SD | $1.44M |
| Avera Mckennan | Sioux Falls, SD | $1.38M |
| Avera Mckennan | Sioux Falls, SD | $857K |
| Avera Mckennan | Sioux Falls, SD | $507K |
| Avera Mckennan | Gregory, SD | $397K |
| Avera Mckennan | Sioux Falls, SD | $307K |
| Avera Mckennan | Sioux Falls, SD | $280K |
| Avera Mckennan | Sioux Falls, SD | $246K |
| Avera Mckennan | Worthington, MN | $240K |
| Avera Mckennan | Windom, MN | $176K |
| Avera Mckennan | Sioux Falls, SD | $104K |
| Avera Mckennan | Sioux Falls, SD | $95K |
| Avera Mckennan | Sioux Falls, SD | $93K |
| Avera Mckennan | Sioux Falls, SD | $62K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.