FRANCIS JAMES MCGOURAN III M.D.
NPI 1205819570
Family Medicine in Duncan, OK

Medicare Participation & PECOS Enrollment Status

Francis Mcgouran is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Francis Mcgouran is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 3870557796

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20041230000002

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE017N)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  10 DME suppliers used 81 Medicare Claims 219 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lancets, per box of 100 (HCPCS:A4259)

  8 DME suppliers used 20 Medicare Claims 22 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lubricant, individual sterile packet, each (HCPCS:A4332)

  1 DME suppliers used 11 Medicare Claims 1620 Services Paid

• DME-Other DME (DE001N)

  Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

  4 DME suppliers used 54 Medicare Claims 54 Services Paid

• DME-Other DME (DE001N)

  Full face mask used with positive airway pressure device, each (HCPCS:A7030)

  4 DME suppliers used 58 Medicare Claims 58 Services Paid

• DME-Other DME (DE001N)

  Face mask interface, replacement for full face mask, each (HCPCS:A7031)

  4 DME suppliers used 41 Medicare Claims 58 Services Paid

• DME-Other DME (DE001N)

  Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

  5 DME suppliers used 34 Medicare Claims 34 Services Paid

• DME-Other DME (DE001N)

  Headgear used with positive airway pressure device (HCPCS:A7035)

  6 DME suppliers used 13 Medicare Claims 13 Services Paid

• DME-Other DME (DE001N)

  Tubing used with positive airway pressure device (HCPCS:A7037)

  6 DME suppliers used 24 Medicare Claims 24 Services Paid

• DME-Other DME (DE001N)

  Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

  9 DME suppliers used 112 Medicare Claims 283 Services Paid

• DME-Other DME (DE001N)

  Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

  4 DME suppliers used 35 Medicare Claims 35 Services Paid

• DME-Other DME (DE001N)

  Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

  4 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Hospital Beds (DB000N)

  Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

  2 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

  6 DME suppliers used 153 Medicare Claims 153 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable oxygen contents, gaseous, 1 month's supply = 1 unit (HCPCS:E0443)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Other DME (DE001N)

  Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)

  1 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  1 DME suppliers used 42 Medicare Claims 42 Services Paid

• DME-Other DME (DE000N)

  Nebulizer, with compressor (HCPCS:E0570)

  3 DME suppliers used 23 Medicare Claims 28 Services Paid

• DME-Other DME (DE001N)

  Continuous positive airway pressure (cpap) device (HCPCS:E0601)

  2 DME suppliers used 23 Medicare Claims 23 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  8 DME suppliers used 246 Medicare Claims 248 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Portable oxygen concentrator, rental (HCPCS:E1392)

  3 DME suppliers used 33 Medicare Claims 33 Services Paid

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  1 DME suppliers used 71 Medicare Claims 71 Services Paid

• DME-Other DME (DE017N)

  Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

  4 DME suppliers used 25 Medicare Claims 25 Services Paid

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

  5 DME suppliers used 26 Medicare Claims 26 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF008N)

  Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

  2 DME suppliers used 13 Medicare Claims 2760 Services Paid

• DME-Orthotic Devices (DF008N)

  Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each (HCPCS:A4352)

  1 DME suppliers used 11 Medicare Claims 1620 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)

  1 DME suppliers used 26 Medicare Claims 520 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)

  1 DME suppliers used 12 Medicare Claims 96 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)

  1 DME suppliers used 12 Medicare Claims 240 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each (HCPCS:A5057)

  1 DME suppliers used 14 Medicare Claims 280 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each (HCPCS:A5063)

  1 DME suppliers used 12 Medicare Claims 240 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier, wipes or swabs, each (HCPCS:A5120)

  2 DME suppliers used 17 Medicare Claims 405 Services Paid

Drugs Administered Through DME

• DME-Drugs Administered Through DME (DG006N)

  Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms (HCPCS:J7606)

  1 DME suppliers used 12 Medicare Claims 720 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

  7 DME suppliers used 18 Medicare Claims 2340 Services Paid

• DME-Drugs Administered Through DME (DG000N)

  Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

  1 DME suppliers used 12 Medicare Claims 720 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscov2 30mcg/0.3ml bst

This is an administration of a COVID-19 vaccine, specifically 30 micrograms in a 0.3 milliliter dosage. The vaccine helps your body build protection against the SARS-CoV-2 virus, which causes COVID-19.

This service was performed 89 times for 88 patients

Adm sarscov2 50mcg/0.25mlbst

This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.

This service was performed 135 times for 125 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 339 times for 335 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 72 times for 72 patients

Advance care planning, first 30 minutes

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

This service was performed 15 times for 15 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 86 times for 86 patients

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 60 times for 37 patients

Assessment of emotional or behavioral problems

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

This service was performed 727 times for 581 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 268 times for 199 patients

Blood glucose (sugar) test performed by hand-held instrument

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

This service was performed 11 times for 11 patients

Blood test, clotting time

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

This service was performed 255 times for 29 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 1,308 times for 653 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 868 times for 573 patients

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 71 times for 35 patients

Destruction of precancer skin growth, 1 growth

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

This service was performed 55 times for 46 patients

Destruction of precancer skin growth, 2-14 growths

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

This service was performed 185 times for 29 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 229 times for 100 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

This service was performed 172 times for 139 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

This service was performed 55 times for 47 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 38 times for 32 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 2,881 times for 811 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 533 times for 382 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 74 times for 73 patients

Fee covid-19 vac 14 res

The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.

This service was performed 84 times for 83 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 40 times for 18 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 539 times for 182 patients

Follow-up nursing facility visit per day, typically 10 minutes

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

This service was performed 539 times for 79 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 15 times for 13 patients

Follow-up observation care per day, typically 25 minutes

Follow-up observation care is a daily service where your health progress is monitored for about 25 minutes. It's a routine check to ensure your treatment is effective and to adjust if necessary. It's a crucial part of your healthcare journey.

This service was performed 27 times for 21 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 1,186 times for 626 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 95 times for 81 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 42 times for 36 patients

Hospital observation care on day of discharge

Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.

This service was performed 32 times for 29 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

This service was performed 62 times for 62 patients

Influenza vaccine, quadrivalent, 0.5 ml dosage

The Influenza vaccine, quadrivalent, 0.5 ml dosage, is a flu shot to protect against four strains of the flu virus. It's given as a small injection, typically in the arm, to help your body build immunity and fight off potential flu infections.

This service was performed 277 times for 273 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 122 times for 106 patients

Initial hospital observation care per day, typically 70 minutes

This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.

This service was performed 29 times for 28 patients

Initial nursing facility visit per day, typically 25 minutes

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

This service was performed 22 times for 21 patients

Injection, ceftriaxone sodium, per 250 mg

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

This service was performed 844 times for 72 patients

Injection, ketorolac tromethamine, per 15 mg

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

This service was performed 109 times for 19 patients

Injection, methylprednisolone acetate, 80 mg

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

This service was performed 48 times for 37 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 326 times for 55 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 1,629 times for 694 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 16 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 26 times for 26 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 46 times for 46 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 214 times for 39 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 82 times for 74 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

This service was performed 150 times for 72 patients

Pneumococcal vaccine, 23-valent

The 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.

This service was performed 72 times for 72 patients

Punch biopsy, first skin growth

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

This service was performed 13 times for 13 patients

Removal of impacted ear wax

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

This service was performed 12 times for 12 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 37 times for 36 patients

Simple or single drainage of skin abscess

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

This service was performed 17 times for 16 patients

Test for detection of infectious agent antibody, qualitative or semiquantitative

This test helps identify if your body has produced antibodies, which are proteins that fight off infections. It is either qualitative (yes/no result) or semiquantitative (measures the amount of antibodies). This can help diagnose certain infectious diseases.

This service was performed 17 times for 17 patients

Testing for presence of drug, read by direct observation

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

This service was performed 47 times for 45 patients

Ultrasound of both sides of head and neck blood flow

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

This service was performed 199 times for 197 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 195 times for 192 patients

Urine microalbumin (protein) analysis

Urine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.

This service was performed 823 times for 496 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 120 times for 99 patients

X-ray of foot, 2 views

An X-ray of the foot, 2 views, is a quick, painless test that produces images of the bones and structures inside your foot. Two different angles are used to provide a comprehensive view. This helps doctors diagnose fractures, infections, or other abnormalities.

This service was performed 19 times for 17 patients

X-ray of knee, 1-2 views

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

This service was performed 13 times for 13 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 23 times for 23 patients

X-ray of shoulder, minimum of 2 views

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

This service was performed 79 times for 61 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.61 for a new patient copayment and $23.56 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 73533 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Francis Mcgouran is affiliated with the following medical facilities:

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Frequently Asked Questions