Physician
Avera Mckennan
Avera Mckennan was paid $4.07M by Medicaid between Jan 2018 and Dec 2024, across 72 billing codes. Its largest line is 99284, emergency room visit (serious) — 44% of everything it billed.
33Billing provider infoAVERA MCKENNAN
SIOUX FALLS, SD 57105
SIOUX FALLS, SD 57105
33aNPI1699985267assigned 05/23/2007
33bProvider typeInternal Medicine Physician
28Total paid$4.07M
24GClaims69,849
24DCodes billed72
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in South Dakota
Rank by total paid#1 of 20
Median peer was paid$6K
This provider vs. median655×
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 | 8,450 | $421K | |
| 2019 | 8,025 | $399K | |
| 2020 | 17,142 | $428K | |
| 2021 | 8,280 | $458K | |
| 2022 | 8,324 | $467K | |
| 2023 | 8,717 | $786K | |
| 2024incomplete | 10,911 | $1.11M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 44% | 22,302 | 18,845 | $1.79M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 26% | 9,052 | 7,789 | $1.06M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 19% | 15,015 | 12,982 | $777K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 3.7% | 5,501 | 4,896 | $151K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 4,985 | 3,741 | $38K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 324 | 243 | $38K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 2,094 | 1,626 | $36K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 953 | 507 | $35K |
| 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 | <1% | 1,401 | 1,152 | $33K |
| 90999 | Dialysis (unlisted procedure)Unlisted dialysis procedure, inpatient or outpatient | <1% | 2,438 | 50 | $31K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 1,098 | 474 | $11K |
| 12011 | <1% | 90 | 80 | $8K |
60 more codes
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 510 | $7K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 511 | $7K |
| 12001 | <1% | 65 | $5K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 210 | $4K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 46 | $4K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 244 | $3K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 95 | $3K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 95 | $2K |
| G0008 | Administration of influenza virus vaccine | <1% | 394 | $2K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | <1% | 108 | $2K |
| 99223 | Prolong inpt eval add15 m | <1% | 60 | $2K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 147 | $2K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 100 | $2K |
| 90837 | Psychotherapy session, about an hour | <1% | 109 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 140 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 100 | $2K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 176 | $2K |
| 93971 | <1% | 75 | $2K | |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 20 | $1K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 47 | $895.61 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 38 | $800.24 |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 64 | $694.75 |
| 99221 | <1% | 31 | $676.28 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 72 | $662.07 |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 23 | $608.90 |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 70 | $598.52 |
| Q3014 | Telehealth originating site facility fee | <1% | 46 | $583.01 |
| 90961 | <1% | 12 | $573.00 | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 39 | $513.05 |
| 90935 | Hemodialysis procedure with single evaluation by a physician | <1% | 34 | $452.60 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 58 | $422.62 |
| 99307 | <1% | 24 | $388.36 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 88 | $372.10 |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 17 | $344.43 |
| E0601 | Continuous positive airway pressure (cpap) device | <1% | 34 | $343.52 |
| 97116 | <1% | 86 | $330.08 | |
| A7031 | Face mask interface, replacement for full face mask, each | <1% | 14 | $329.83 |
| A7030 | Full face mask used with positive airway pressure device, each | <1% | 13 | $314.76 |
| Q0513 | Pharmacy dispensing fee for inhalation drug(s); per 30 days | <1% | 46 | $244.20 |
| 71045 | Radiologic examination, chest; single view | <1% | 134 | $218.90 |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 15 | $192.90 |
| A4604 | Tubing with integrated heating element for use with positive airway pressure device | <1% | 19 | $185.20 |
| 20610 | <1% | 13 | $175.26 | |
| 93970 | <1% | 21 | $165.00 | |
| 99152 | <1% | 64 | $156.16 | |
| E1392 | Portable oxygen concentrator, rental | <1% | 24 | $156.02 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | <1% | 27 | $130.01 |
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | <1% | 39 | $127.41 |
| 93296 | <1% | 16 | $116.53 | |
| E0562 | Humidifier, heated, used with positive airway pressure device | <1% | 12 | $113.19 |
| K0738 | Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing | <1% | 15 | $105.77 |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 13 | $93.28 |
| A7035 | Headgear used with positive airway pressure device | <1% | 15 | $75.95 |
| A7038 | Filter, disposable, used with positive airway pressure device | <1% | 21 | $67.28 |
| A4357 | Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each | <1% | 12 | $40.21 |
| E0570 | Nebulizer, with compressor | <1% | 25 | $39.85 |
| A7046 | Water chamber for humidifier, used with positive airway pressure device, replacement, each | <1% | 12 | $32.94 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 12 | $29.04 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 12 | $11.33 |
| 36415 | Collection of venous blood by venipuncture | 0% | 14 | $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 | $3.71M |
| 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.