Physician
Fallingwater Medical Associates, PLLC
Fallingwater Medical Associates, PLLC was paid $836K by Medicaid between Jan 2018 and Nov 2024, across 29 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 75% of everything it billed.
33Billing provider infoFALLINGWATER MEDICAL ASSOCIATES, PLLC
DUNCAN, OK 73533
DUNCAN, OK 73533
33aNPI1538109319assigned 06/08/2006
33bProvider typeFamily Medicine Physician
28Total paid$836K
24GClaims21,895
24DCodes billed29
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in Oklahoma
Rank by total paid#71 of 351
Median peer was paid$153K
This provider vs. median5.5×
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 | 3,429 | $98K | |
| 2019 | 2,935 | $97K | |
| 2020 | 2,778 | $101K | |
| 2021 | 3,532 | $145K | |
| 2022 | 3,946 | $167K | |
| 2023 | 2,823 | $120K | |
| 2024incomplete | 2,452 | $108K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 75% | 12,407 | 10,708 | $626K |
| 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 | 11% | 1,387 | 1,320 | $94K |
| 99307 | 2.8% | 2,657 | 2,507 | $24K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 2.2% | 477 | 467 | $18K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.8% | 557 | 543 | $15K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.0% | 101 | 96 | $9K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 155 | 153 | $8K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 272 | 101 | $6K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 395 | 386 | $5K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 134 | 134 | $4K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 195 | 194 | $3K |
| 80061 | Lipid panel | <1% | 300 | 300 | $3K |
17 more codes
| 99223 | Prolong inpt eval add15 m | <1% | 24 | $3K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 435 | $3K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 324 | $3K |
| 96127 | <1% | 687 | $2K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 144 | $2K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 184 | $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% | 376 | $1K |
| 90688 | <1% | 98 | $1K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 25 | $806.68 |
| 87807 | <1% | 64 | $731.91 | |
| G0008 | Administration of influenza virus vaccine | <1% | 279 | $660.85 |
| 0011A | <1% | 15 | $461.64 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 20 | $239.75 |
| 80305 | <1% | 12 | $134.52 | |
| 82044 | <1% | 24 | $132.68 | |
| 96160 | <1% | 110 | $2.84 | |
| 90686 | 0% | 37 | $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 officialMCGOURAN, FRANCIS (PHYSICIAN)
| Provider | Location | Paid |
|---|---|---|
| Falling Water Medical Associates, PLLC | Duncan, OK | $63K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.