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 1851396394)

Key Findings

Field	Value
Entity Type	Organization
Organization	Duncan Regional Hospital, Inc.
Address	1415 N Whisenant Dr
City	Duncan
State	OK
ZIP	73533
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	June 20, 2005

Payer Source	Total Paid
Medicaid	$17.8M
Medicare	$0

DUNCAN REGIONAL HOSPITAL, INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file while Medicaid revenue totals $17.8M. The absence of Medicare activity makes Medicaid the primary and near-exclusive public payer in the available claims data for this facility.

Revenue is highly concentrated in emergency department evaluation-and-management services: the three ED E/M codes 99284 ($5.2M, 30.4%), 99285 ($3.8M, 22.1%), and 99283 ($3.3M, 19.3%) together account for 71.8% of the provider’s total Medicaid revenue. This concentration indicates that a large share of the hospital’s Medicaid billing and revenue base is generated by moderate-to-high acuity emergency care.

The volume counts on core ED codes underline a high-throughput emergency department operation: 99284 shows 22K claims, 99283 shows 20.1K claims, and 99285 shows 12.3K claims, reflecting consistent ED visit activity across low-, moderate-, and high-complexity encounters. Those claim volumes, paired with the revenue shares above, suggest the hospital functions as a regional ED access point for Medicaid populations.

Competitive standing for the top ED codes is solid but described as typical in-state: 99284 ranks #21 of 230 (91th percentile; typical, unremarkable volume), 99285 ranks #21 of 182 (89th percentile; typical, unremarkable volume), and 99283 ranks #28 of 254 (89th percentile; typical, unremarkable volume). In other words, the hospital sits in the upper percentiles for ED billing versus state peers but the dataset labels its volumes as within the typical range rather than uniquely dominant.

The provider reports notably elevated infusion and IV administration activity, consistent with ED or acute inpatient throughput: 96374 has 11.8K claims and $1.4M revenue (8.1%; ranks #8 of 95, 93th percentile; notably above typical), 96375 has 7.6K claims and $312.7K revenue (1.8%; ranks #7 of 90, 93th percentile; notably above typical), and 96361 (4K claims, $144K) ranks #5 of 71 (94th percentile; notably above typical). These patterns indicate frequent use of IV push and infusion services as part of the hospital’s care mix.

Behavioral-health group psychotherapy stands out as an unusual service-volume outlier for the facility: 90853 shows 12.2K claims and $73.4K revenue (0.4%) while ranking #1 of 14 providers in-state (100th percentile; extreme outlier, far above typical state volume). That extreme percentile suggests the hospital provides group therapy at a scale uncommon among its state peers and may operate a sizable group-based behavioral health program within its Medicaid population.

High throughput laboratory and basic imaging support the ED/inpatient workflow: 80053 (CMP) has 16.9K claims and $151.7K revenue (0.9%; ranks #15 of 154, 91th percentile), 36415 (blood draw) has 12.3K claims and $86.3K revenue (0.5%; ranks #14 of 423, 97th percentile; notably above typical), and 87637 (multiplex respiratory NAAT) has 2.4K claims and $327.1K revenue (1.9%; ranks #3 of 26, 92th percentile). These lab and phlebotomy volumes are consistent with emergency and acute-care throughput to support the facility’s dominant ED revenue drivers.

Operational longevity is established: the provider’s NPI was enumerated on 2005-06-20 (~21 years ago), indicating long-standing service in the community. Combined with the concentrated Medicaid revenue mix and the lack of Medicare billing on file, the hospital appears to be an established rural acute-care ED hub whose financial exposure is largely tied to Medicaid reimbursement trends rather than diversified payer mix.

Medicaid: Complete Services Breakdown

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

112 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	22,010	$240	$5.2M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	12,310	$310	$3.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	20,080	$160	$3.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11,810	$120	$1.4M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,910	$160	$474.3K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2,420	$140	$327.1K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	7,630	$40	$312.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	4,120	$60	$246.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	3,420	$70	$235.7K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	3,320	$70	$222.4K

Showing 1–10 of 112

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. — 3 of 25 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

112 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	21	230	1,440	$170	$1.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	28	250	1,820	$130	$1.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	21	180	1,030	$200	$1M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	73	200	1,720	$80	$645.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	19	20	580	$140	$627K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	84	210	1,850	$70	$560.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	35	50	70	$1,800	$496.5K
80081	The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens…	2	10	170	$70	$447.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	8	100	990	$130	$405.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	37	70	150	$450	$279K

Showing 1–10 of 112

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
Lora Minson	OK	Family Nurse Practitioner	$294.8K	$0

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

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

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Duncan Regional Hospital, Inc.	OK	Rural Health Clinic/Center	$0	$2.3M
Adam Savage	OK	Pain Medicine (Anesthesiology) Physician	$1.2M	$0
Douglas Miller	OK	Surgery Physician	$543.8K	$0
Joshua Gordon	OK	Anesthesiology Physician	$514.6K	$0
Francis Mcgouran	OK	Family Medicine Physician	$473K	$0
John Hennessee	OK	Psychiatry Physician	$415.1K	$5.3K