Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oklahoma for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oklahoma only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oklahoma (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Duncan Regional Hospital, Inc. (NPI 1609317247)

Field	Value
Entity Type	Organization
Organization	Duncan Regional Hospital, Inc.
Address	1314 Harville Rd. Ste 200, 300 & 601
City	Duncan
State	OK
ZIP	73533
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 15, 2017

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	6,370	$190	$1.2M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	3,550	$230	$810.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	300	$250	$76.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	300	$260	$76.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	160	$260	$39.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	630	$30	$17.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	770	$20	$13.8K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	50	$200	$9.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	80	$70	$5.8K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	110	$50	$5.7K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.

Claims Volume vs. Oklahoma Distribution

Duncan Regional Hospital, Inc. — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. Oklahoma median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	196	1,680	820	$90	$307K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	401	1,750	870	$70	$254.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	167	270	600	$90	$159.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	162	280	470	$100	$140.8K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	481	720	120	$150	$94.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	125	160	130	$90	$84.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	155	290	200	$90	$72.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	233	290	260	$40	$69.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	92	130	330	$20	$67.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	103	240	360	$30	$56.9K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Duncan Regional Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duncan Regional Hospital, Inc.	OK	Rural Acute Care Hospital	$0	$17.8M
Duncan Regional Hospital, Inc.	OK	Rural Health Clinic/Center	$0	$4.7M
Duncan Regional Hospital, Inc	OK	Rural Health Clinic/Center	$0	$4.2M
Duncan Regional Hospital, Inc	OK	Rural Health Clinic/Center	$0	$3.6M
Duncan Regional Hospital, Inc.	OK	Rural Health Clinic/Center	$0	$3.4M
Jefferson County Hospital	MS	Rural Acute Care Hospital	$0	$2.8M
Duncan Guedon	MS	Obstetrics & Gynecology Physician	$8.1K	$1.7M
Adam Savage	OK	Pain Medicine (Anesthesiology) Physician	$1.2M	$0
Clifford Tillman	LA	Gastroenterology Physician	$439.4K	$268.7K
Douglas Miller	OK	Surgery Physician	$543.8K	$0

Nearby Providers

Other providers in the same ZIP code as Duncan Regional Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Association South Central Oklahoma Governments	OK	Case Management Agency	$0	$5.9M
Urgent Med LLC	OK	Urgent Care Clinic/Center	$0	$3.9M
Chisholm Trail Retirement Community	OK	Assisted Living Facility	$0	$3.5M
Sooner Mobile X-ray, Inc.	OK	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1.1M	$1.4M
Solutions Practice Management	OK	Family Medicine Physician	$0	$2M
Duncan Family Eye Care Inc	OK	Optometrist	$0	$1.9M
Amy Shultz	OK	Rheumatology Physician	$1.7M	$0
Jim Taliaferro Cmhc	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.6M
Air Evac Ems Inc	OK	Air Ambulance	$1M	$180K
Francis Mcgouran	OK	Family Medicine Physician	$473K	$0

Duncan Regional Hospital, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References