AVERA MCKENNAN
NPI: 1760681175
· FLANDREAU, SD 57028
· Public Health or Welfare Agency
· NPI assigned 07/16/2007
$395.24
Total Medicaid Paid
Provider Details
| Authorized Official | SHEA, BARB (BUSINESS OFFICE ASSISTANT) |
| NPI Enumeration Date | 07/16/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
77 |
$395.24 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
42 |
$395.24 |
| 90686 |
|
35 |
35 |
$0.00 |