Avera Marshall
Avera Marshall was paid $10.02M by Medicaid between Jan 2018 and Dec 2024, across 124 billing codes. Its largest line is 99283, emergency room visit (moderate) — 12% of everything it billed.
MARSHALL, MN 56258
Next to other Critical Access Hospital providers in Minnesota
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 | 11,651 | $216K | |
| 2019 | 18,253 | $903K | |
| 2020 | 41,905 | $1.89M | |
| 2021 | 62,159 | $3.28M | |
| 2022 | 18,936 | $1.20M | |
| 2023 | 20,334 | $1.46M | |
| 2024incomplete | 10,843 | $1.06M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 12% | 12,015 | 9,936 | $1.21M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 10.0% | 8,427 | 6,749 | $998K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.4% | 17,058 | 14,688 | $839K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 8.1% | 21,900 | 19,263 | $815K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 6.7% | 6,527 | 5,727 | $676K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 6.4% | 2,768 | 1,850 | $637K |
| 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 | 5.7% | 7,987 | 7,126 | $574K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 4.9% | 5,157 | 1,833 | $493K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 4.4% | 4,155 | 1,502 | $438K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 3.6% | 7,614 | 5,581 | $358K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.7% | 5,329 | 4,541 | $271K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2.7% | 3,549 | 3,126 | $266K |
112 more codes
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.3% | 3,064 | $228K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.2% | 2,754 | $216K |
| 36415 | Collection of venous blood by venipuncture | 1.9% | 10,232 | $194K |
| 80053 | Comprehensive metabolic panel | 1.8% | 6,856 | $180K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.4% | 8,790 | $137K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 1.1% | 5,234 | $114K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 1.1% | 1,660 | $113K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.0% | 861 | $103K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 1,616 | $89K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 1,087 | $83K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 636 | $73K |
| 92587 | <1% | 754 | $64K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 866 | $58K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 670 | $54K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 1,480 | $53K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 681 | $52K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 1,167 | $46K |
| J0178 | Injection, aflibercept, 1 mg | <1% | 37 | $40K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 451 | $38K |
| J3490 | Unclassified drugs | <1% | 1,409 | $36K |
| 92134 | <1% | 1,499 | $31K | |
| 67028 | Intravitreal injection of a pharmacologic agent | <1% | 492 | $29K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 287 | $28K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,901 | $21K |
| 81001 | <1% | 1,609 | $21K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 229 | $19K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | <1% | 805 | $19K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 1,646 | $18K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 382 | $17K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 169 | $15K |
| 87634 | <1% | 99 | $13K | |
| 80061 | Lipid panel | <1% | 766 | $13K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 353 | $13K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 254 | $10K |
| 92551 | <1% | 67 | $10K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 311 | $10K |
| 92567 | <1% | 814 | $10K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 793 | $9K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,797 | $9K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 516 | $9K |
| X5622 | <1% | 294 | $8K | |
| 0240U | <1% | 41 | $7K | |
| 90686 | <1% | 2,296 | $7K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 245 | $7K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 43 | $7K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 230 | $7K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 189 | $6K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 16 | $6K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 34 | $6K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 38 | $6K |
| 92557 | <1% | 256 | $6K | |
| 0002A | <1% | 155 | $5K | |
| 73630 | <1% | 50 | $4K | |
| 0001A | <1% | 147 | $4K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 159 | $4K |
| 85610 | <1% | 218 | $4K | |
| 71045 | Radiologic examination, chest; single view | <1% | 58 | $3K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 581 | $3K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 16 | $3K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 188 | $3K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 103 | $3K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 47 | $3K |
| 99383 | <1% | 36 | $3K | |
| A9270 | Non-covered item or service | <1% | 4,544 | $3K |
| 84484 | <1% | 106 | $2K | |
| 84439 | <1% | 132 | $2K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 32 | $2K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 83 | $2K |
| 92015 | Determination of refractive state | <1% | 185 | $2K |
| 83605 | <1% | 75 | $2K | |
| 11721 | <1% | 78 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 182 | $2K |
| 86780 | <1% | 146 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 59 | $1K |
| 83690 | <1% | 74 | $1K | |
| 36416 | <1% | 27 | $1K | |
| 86803 | <1% | 57 | $1K | |
| 96161 | <1% | 156 | $1K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 76 | $1K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 27 | $973.94 |
| 85027 | <1% | 187 | $952.93 | |
| J2704 | Injection, propofol, 10 mg | <1% | 38 | $887.52 |
| 96127 | <1% | 371 | $789.55 | |
| 97802 | <1% | 13 | $677.96 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 14 | $566.07 |
| 83655 | <1% | 38 | $493.43 | |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | <1% | 13 | $401.77 |
| 93041 | <1% | 32 | $347.66 | |
| 99188 | <1% | 326 | $342.39 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 42 | $298.95 |
| 90473 | <1% | 123 | $289.12 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 12 | $201.53 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 69 | $170.12 |
| 87340 | <1% | 13 | $152.76 | |
| Q3014 | Telehealth originating site facility fee | <1% | 13 | $85.36 |
| 82950 | <1% | 13 | $73.79 | |
| 85018 | <1% | 23 | $46.52 | |
| 90461 | <1% | 18 | $42.99 | |
| 94761 | <1% | 14 | $36.09 | |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 56 | $25.25 |
| 90633 | <1% | 73 | $16.16 | |
| 90474 | <1% | 12 | $7.75 | |
| 90647 | 0% | 251 | $0.00 | |
| 90680 | 0% | 128 | $0.00 | |
| 90723 | 0% | 280 | $0.00 | |
| 90651 | 0% | 33 | $0.00 | |
| 90670 | 0% | 623 | $0.00 | |
| 90715 | 0% | 31 | $0.00 | |
| 90710 | 0% | 28 | $0.00 | |
| 99173 | 0% | 85 | $0.00 | |
| 90734 | 0% | 33 | $0.00 | |
| 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | 0% | 17 | $0.00 |
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 Marshall | Marshall, MN | $1.72M |
| Avera Marshall | Marshall, MN | $669K |
| Avera Marshall | Marshall, MN | $381K |
| Avera Tyler | Tyler, MN | $342K |
| Avera Tyler | Tyler, MN | $182K |
| Avera Marshall | Marshall, MN | $132K |
| Avera Marshall | Redwood Falls, MN | $92K |
| Avera Marshall | Marshall, MN | $81K |
| Avera Marshall | Marshall, MN | $49K |
| Avera Marshall | Marshall, MN | $47K |
| Avera ST. Luke's | Aberdeen, SD | $45K |
| Avera Marshall | Marshall, MN | $27K |
| Avera Tyler | Lake Benton, MN | $26K |
| Avera Granite Falls | Granite Falls, MN | $21K |
| Avera Marshall | Canby, MN | $6K |
| Avera Marshall | Tracy, MN | $1K |
| Avera Marshall | Marshall, MN | $1K |
| Avera Tyler | Ivanhoe, MN | $313.94 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.