Avera Mckennan
Avera Mckennan was paid $507K by Medicaid between Jan 2018 and Nov 2024, across 16 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 33% of everything it billed.
SIOUX FALLS, SD 57108
Next to other Internal Medicine 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 | 2,299 | $62K | |
| 2019 | 1,835 | $50K | |
| 2020 | 752 | $23K | |
| 2021 | 2,121 | $72K | |
| 2022 | 2,140 | $95K | |
| 2023 | 2,349 | $97K | |
| 2024incomplete | 2,845 | $109K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 33% | 4,155 | 3,499 | $170K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 28% | 4,529 | 1,399 | $140K |
| W0037 | 15% | 1,297 | 1,297 | $74K | |
| 99222 | Initial hospital care, per day, moderate complexity | 9.3% | 620 | 573 | $47K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.5% | 1,307 | 1,124 | $33K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 2.9% | 672 | 507 | $15K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 2.4% | 682 | 351 | $12K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 1.7% | 312 | 256 | $9K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | <1% | 68 | 28 | $3K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 45 | 39 | $1K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 548 | 499 | $941.64 |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 21 | 15 | $884.09 |
4 more codes
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 | $445K |
| 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.