Hospital
Avera Mckennan
Avera Mckennan was paid $3.71M by Medicaid between Jan 2018 and Dec 2024, across 92 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 24% of everything it billed.
33Billing provider infoAVERA MCKENNAN
SIOUX FALLS, SD 57105
SIOUX FALLS, SD 57105
33aNPI1568460772assigned 07/12/2005
33bProvider typeGeneral Acute Care Hospital
28Total paid$3.71M
24GClaims173,203
24DCodes billed92
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Dakota
Rank by total paid#4 of 17
Median peer was paid$547K
This provider vs. median6.8×
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.
Entity ProliferationAuthorized official PLACE, RONALD controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 27,890 | $527K | |
| 2019 | 24,534 | $433K | |
| 2020 | 12,266 | $259K | |
| 2021 | 27,303 | $542K | |
| 2022 | 30,146 | $636K | |
| 2023 | 25,695 | $528K | |
| 2024incomplete | 25,369 | $787K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 24% | 72,584 | 24,957 | $882K |
| A9270 | Non-covered item or service | 18% | 27,153 | 7,491 | $685K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 15% | 8,188 | 6,949 | $566K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 7.1% | 18,034 | 1,951 | $264K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 4.5% | 7,774 | 2,061 | $165K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 3.7% | 1,602 | 1,496 | $138K |
| 80053 | Comprehensive metabolic panel | 3.5% | 633 | 517 | $130K |
| 95886 | 3.4% | 779 | 702 | $125K | |
| J3490 | Unclassified drugs | 3.2% | 1,946 | 1,155 | $119K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 1.9% | 1,969 | 1,686 | $70K |
| 36415 | Collection of venous blood by venipuncture | 1.7% | 1,395 | 1,135 | $64K |
| 95913 | 1.5% | 326 | 288 | $57K |
80 more codes
| J0585 | Injection, onabotulinumtoxina, 1 unit | 1.4% | 532 | $54K |
| G0378 | Hospital observation service, per hour | 1.3% | 3,788 | $48K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 126 | $27K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 193 | $27K |
| G0008 | Administration of influenza virus vaccine | <1% | 2,263 | $23K |
| 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 | <1% | 1,933 | $23K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 147 | $22K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 455 | $21K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 144 | $19K |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | <1% | 541 | $19K |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 767 | $18K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 73 | $14K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,852 | $12K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 13 | $11K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 3,103 | $10K |
| 90837 | Psychotherapy session, about an hour | <1% | 1,358 | $10K |
| 99285 | Emergency room visit (most serious) | <1% | 322 | $9K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 169 | $8K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,246 | $7K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,126 | $7K |
| 41899 | Unlisted procedure, dentoalveolar structures | <1% | 85 | $6K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,285 | $6K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 218 | $5K |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | <1% | 112 | $5K |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 232 | $5K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 134 | $3K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 106 | $3K |
| 95887 | <1% | 168 | $3K | |
| 0240U | <1% | 28 | $3K | |
| J2704 | Injection, propofol, 10 mg | <1% | 3,005 | $2K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 255 | $2K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 97 | $2K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 16 | $2K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 14 | $1K |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 1,145 | $1K |
| 0124A | <1% | 188 | $1K | |
| G0009 | Administration of pneumococcal vaccine | <1% | 235 | $1K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 60 | $1K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 81 | $752.96 |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 38 | $687.92 |
| 92587 | <1% | 16 | $498.40 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 88 | $482.42 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | <1% | 19 | $411.84 |
| 87480 | <1% | 15 | $411.04 | |
| 0054A | <1% | 63 | $382.41 | |
| 90480 | <1% | 160 | $370.43 | |
| J0689 | Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg | <1% | 370 | $289.75 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 85 | $261.32 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 340 | $208.95 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | $184.42 |
| 84439 | <1% | 85 | $176.10 | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 24 | $165.20 |
| 99334 | <1% | 13 | $155.35 | |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 15 | $120.63 |
| 71045 | Radiologic examination, chest; single view | <1% | 30 | $95.99 |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 17 | $94.18 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 15 | $93.81 |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 15 | $87.65 |
| 86140 | <1% | 57 | $76.08 | |
| 85027 | <1% | 58 | $59.68 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 20 | $40.21 |
| 85610 | <1% | 57 | $31.48 | |
| 85652 | <1% | 72 | $28.41 | |
| 90662 | <1% | 50 | $23.75 | |
| 82785 | <1% | 21 | $22.36 | |
| 87510 | <1% | 15 | $20.05 | |
| 87660 | <1% | 15 | $20.05 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 18 | $20.00 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 92 | $2.45 |
| 86780 | 0% | 16 | $0.00 | |
| 90686 | 0% | 103 | $0.00 | |
| J7050 | Infusion, normal saline solution, 250 cc | 0% | 12 | $0.00 |
| 90694 | 0% | 33 | $0.00 | |
| 87077 | 0% | 32 | $0.00 | |
| 90656 | 0% | 18 | $0.00 | |
| 82657 | 0% | 15 | $0.00 | |
| 86850 | 0% | 16 | $0.00 | |
| 91322 | 0% | 37 | $0.00 | |
| 90653 | 0% | 15 | $0.00 | |
| 80076 | 0% | 12 | $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.
From NPPES
Who's on the registration
Authorized officialPLACE, RONALD (PRESIDENT/CEO)
| Provider | Location | Paid |
|---|---|---|
| Avera Mckennan | Sioux Falls, SD | $6.68M |
| Avera Mckennan | Sioux Falls, SD | $5.34M |
| Avera Mckennan | Sioux Falls, SD | $4.07M |
| Avera Mckennan | Sioux Falls, SD | $3.24M |
| Avera Mckennan | Sioux Falls, SD | $1.04M |
| Avera Mckennan | Sioux Falls, SD | $1.03M |
| Avera Mckennan | Sioux Falls, SD | $902K |
| Avera Mckennan | Milbank, SD | $899K |
| Avera Mckennan | Sioux Falls, SD | $815K |
| Avera Mckennan | Sioux Falls, SD | $758K |
| Avera Mckennan | Sioux Falls, SD | $545K |
| Avera Mckennan | Sioux Falls, SD | $318K |
| Avera Mckennan | Rock Rapids, IA | $186K |
| Avera Mckennan | Sioux Falls, SD | $156K |
| Avera Mckennan | Gregory, SD | $80K |
| Avera Mckennan | Mitchell, SD | $70K |
| Avera Mckennan | Sioux Falls, SD | $68K |
| Avera Mckennan | Sioux Falls, SD | $54K |
| Avera Mckennan | Sioux Falls, SD | $54K |
| Avera Mckennan | Flandreau, SD | $53K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.