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 1902347651)

Duncan Regional Hospital, Inc is a rural health clinic/center provider located in Duncan, Oklahoma. This profile covers 0 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Duncan Regional Hospital, Inc
Address	1315 Whisenant Ct Ste 100-301
City	Duncan
State	OK
ZIP	73533
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 14, 2017

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	9,990	$240	$2.4M
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…	4,480	$200	$890.7K
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…	960	$210	$201.2K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	110	$170	$18.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	80	$60	$4.5K
99203	The provider sees a new 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 provider…	30	$160	$4K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	10	$10	$130
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	10	$10	$90
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	10	$1	$30

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 9 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

9 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…	267	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…	161	1,750	870	$70	$254.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	58	80	190	$80	$148.9K
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…	112	720	120	$150	$94.5K
99203	The provider sees a new 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 provider…	572	710	140	$100	$74.6K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	53	150	60	$210	$50.3K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	153	160	330	$10	$17.8K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	149	160	200	$10	$6.7K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	108	120	250	$1	$3.8K

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	$3.4M
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

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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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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