Physician
James H Duncan DO INC
James H Duncan DO INC was paid $396K by Medicaid between Jan 2018 and Dec 2024, across 24 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 95% of everything it billed.
33Billing provider infoJAMES H DUNCAN DO INC
WEST PORTSMOUTH, OH 45663
WEST PORTSMOUTH, OH 45663
33aNPI1295047348assigned 07/06/2010
33bProvider typeFamily Medicine Physician
28Total paid$396K
24GClaims13,341
24DCodes billed24
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Ohio
Rank by total paid#120 of 739
Median peer was paid$30K
This provider vs. median13×
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.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,315 | $34K | |
| 2019 | 2,261 | $63K | |
| 2020 | 1,477 | $61K | |
| 2021 | 1,532 | $56K | |
| 2022 | 2,249 | $61K | |
| 2023 | 2,114 | $63K | |
| 2024incomplete | 2,393 | $58K |
Box 24 · Service lines
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 | 95% | 7,800 | 6,584 | $376K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 100 | 93 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 137 | 108 | $2K |
| 36416 | <1% | 1,377 | 1,190 | $2K | |
| 82947 | <1% | 1,376 | 1,186 | $2K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 50 | 42 | $2K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 513 | 468 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 81 | 68 | $1K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 16 | 13 | $1K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 21 | 21 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 142 | 110 | $1K |
| 96127 | <1% | 179 | 156 | $678.99 |
12 more codes
| 93000 | <1% | 49 | $592.06 | |
| 90756 | <1% | 30 | $397.09 | |
| 90686 | <1% | 14 | $198.09 | |
| 90688 | <1% | 20 | $148.25 | |
| 99406 | <1% | 17 | $77.32 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 255 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 163 | $0.00 |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 0% | 233 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 135 | $0.00 |
| 99000 | 0% | 217 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 121 | $0.00 |
| 1000F | 0% | 295 | $0.00 |
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.
From NPPES
Who's on the registration
Authorized officialDUNCAN, JAMES (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Chelsea Chiropractic Center, PLC | Chelsea, MI | $50K |
| James Duncan MD Consulting Service PLLC | Danville, KY | $7K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.