Active NPI 1588659957 Individual Practitioner Male Practitioner

Dr. Glen Edward Diacon , MD

Specialist • Ada, OK

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Glen Diacon, MD is a certified Specialist practicing in Ada, OK. With approximately 40 years of clinical experience since graduating from University Of Oklahoma College Of Medicine in 1986, Dr. Diacon delivers high-quality medical care to the local community at 1414 ARLINGTON ST.

Dr. Diacon maintains professional affiliations with Chickasaw Nation Division Of Health, Southern Oklahoma Urology, Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, automated urinalysis test, imaging of urinary tract. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1414 Arlington St
Suite 2300

Ada, OK 748202643

Telephone 5803320112

Fax 5803321005

Associated Practice Facility / Clinic

🏢 Southern Oklahoma Urology, Inc Facility NPI 1528254109

Medicare Profile & Education

Medical School

University Of Oklahoma College Of Medicine

Graduation Year

1986

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Ada, OK

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

40 Yrs -12.5 yrs vs City Avg

City Avg: 52.5 Yrs

State Avg: 38.7 Yrs

Regional Practice Density

10 Specialists

Practicing in Ada, OK (463 Statewide)

Telehealth Adoption Rate

10.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

48.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Diacon (40 Years) 40 Yrs

Ada Specialty Average (52.5 Years) 52.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,674	846	$215.01	$117.89
81003 Automated urinalysis test	1,154	644	$5.00	$2.18
74420 Imaging of urinary tract	419	312	$42.75	$22.48
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	311	93	$111.38	$73.36
52000 Diagnostic exam of bladder and urethra using an endoscope	269	245	$386.00	$211.33
51798 Ultrasound measurement of bladder capacity after voiding	257	222	$25.00	$9.80
50590 Shock wave crushing of kidney stones	251	183	$956.74	$520.51
51741 Electronic assessment of bladder emptying	225	199	$23.12	$12.94
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	108	36	$86.71	$46.60
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	106	17	$400.00	$174.81
52281 Dilation of bladder canal (urethra) using an endoscope	83	24	$531.93	$292.56
52332 Insertion of stent in urinary duct (ureter) using an endoscope	60	42	$270.77	$95.51
51702 Simple insertion of temporary bladder tube	45	22	$103.93	$56.07
76872 Ultrasound scan of pelvic region through rectum	43	43	$301.25	$123.71
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	41	41	$172.92	$110.84
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	37	37	$353.36	$182.89
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	36	34	$204.34	$121.32
55700 Biopsy of prostate gland	35	35	$411.88	$219.13
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	27	17	$52.36	$30.72
52341 Treatment of stricture in urinary duct (ureter) using an endoscope	25	21	$477.28	$245.02
64561 Insertion of sacral nerve neurostimulator electrode array	23	22	$1002.80	$421.42
52005 Insertion of tube into ureter using an endoscope through bladder area	21	21	$222.16	$104.33
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	17	16	$301.51	$160.47
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	16	$700.23	$292.18
95972 Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming	16	16	$69.83	$37.23
64595 Revision or removal of peripheral nerve or gastric neurostimulator generator	13	13	$210.33	$204.02
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	13	13	$369.48	$191.31
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	13	12	$36.75	$20.94
64585 Revision of peripheral neurostimulator electrodes	12	12	$239.65	$69.72
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	11	11	$1228.61	$677.25
51715 Injection of implant material beneath lining of bladder and/or urethra using an endoscope	11	11	$337.30	$184.24
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver	11	11	$269.13	$194.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,644	809	$214.44	$119.86
81003 Automated urinalysis test	1,108	602	$5.10	$2.19
74420 Imaging of urinary tract	402	313	$42.39	$23.56
51798 Ultrasound measurement of bladder capacity after voiding	287	240	$25.00	$9.53
52000 Diagnostic exam of bladder and urethra using an endoscope	283	259	$384.56	$219.86
50590 Shock wave crushing of kidney stones	243	188	$956.82	$534.74
51741 Electronic assessment of bladder emptying	243	213	$23.12	$13.16
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	216	70	$119.77	$75.86
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	121	38	$86.71	$48.07
52005 Insertion of tube into ureter using an endoscope through bladder area	96	89	$223.21	$76.04
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	78	15	$400.00	$170.05
52281 Dilation of bladder canal (urethra) using an endoscope	71	24	$548.49	$304.08
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	63	60	$172.92	$114.64
52332 Insertion of stent in urinary duct (ureter) using an endoscope	63	47	$270.28	$97.39
J0696 Injection, ceftriaxone sodium, per 250 mg	45	12	$3.67	$0.50
76872 Ultrasound scan of pelvic region through rectum	41	41	$301.25	$123.45
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	39	38	$353.36	$196.21
55700 Biopsy of prostate gland	34	34	$411.88	$218.94
51702 Simple insertion of temporary bladder tube	33	16	$103.93	$57.11
64561 Insertion of sacral nerve neurostimulator electrode array	33	33	$1024.98	$429.14
95972 Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming	27	27	$69.83	$38.89
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver	27	27	$268.60	$79.08
64581 Incision to insert sacral nerve neurostimulator electrodes	26	26	$1099.97	$627.38
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	21	15	$52.36	$31.05
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	21	15	$36.20	$21.42
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	18	18	$301.51	$163.28
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	17	$700.23	$265.44
52281 Dilation of bladder canal (urethra) using an endoscope	16	16	$254.75	$134.52
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	13	13	$1228.61	$691.79
52630 Removal of remaining or regrown prostate tissue with control of bleeding using an endoscope	12	11	$676.31	$368.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,500	775	$215.20	$120.48
81003 Automated urinalysis test	1,373	708	$5.00	$2.21
74420 Imaging of urinary tract	346	286	$42.25	$23.76
52000 Diagnostic exam of bladder and urethra using an endoscope	313	282	$384.33	$226.32
50590 Shock wave crushing of kidney stones	234	170	$955.53	$532.54
51798 Ultrasound measurement of bladder capacity after voiding	214	192	$25.00	$9.36
51741 Electronic assessment of bladder emptying	188	172	$23.12	$12.99
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	185	58	$120.05	$68.29
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	96	31	$86.71	$48.41
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	84	14	$400.00	$174.69
76775 Limited ultrasound scan behind abdominal cavity	79	77	$96.44	$54.55
52332 Insertion of stent in urinary duct (ureter) using an endoscope	70	48	$263.49	$99.12
J0696 Injection, ceftriaxone sodium, per 250 mg	68	15	$1.00	$0.50
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	61	55	$172.92	$98.19
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	54	12	$31.00	$13.47
76872 Ultrasound scan of pelvic region through rectum	54	53	$301.25	$129.54
99441 Telephone medical discussion with physician, 5-10 minutes	54	31	$99.71	$42.91
52005 Insertion of tube into ureter using an endoscope through bladder area	53	53	$222.80	$76.18
55700 Biopsy of prostate gland	41	41	$411.88	$229.33
52281 Dilation of bladder canal (urethra) using an endoscope	40	22	$534.27	$309.42
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	31	31	$379.58	$200.71
64561 Insertion of sacral nerve neurostimulator electrode array	27	27	$948.99	$433.39
52356 Crushing of stone of ureter with insertion of stent using an endoscope	23	19	$700.23	$284.99
52281 Dilation of bladder canal (urethra) using an endoscope	21	19	$254.75	$120.88
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	20	14	$52.36	$30.59
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	17	17	$301.51	$172.07
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	16	16	$1228.61	$701.58
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$227.50	$123.34
95972 Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming	14	14	$69.83	$36.52
64581 Incision to insert sacral nerve neurostimulator electrodes	13	13	$1117.31	$593.69
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver	13	13	$269.13	$70.83
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	12	12	$36.75	$21.54
51040 Incision of bladder with drainage	12	12	$479.54	$254.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,478	796	$183.21	$119.76
81003 Automated urinalysis test	1,473	781	$5.00	$2.24
74420 Imaging of urinary tract	365	287	$36.93	$24.24
52000 Diagnostic exam of bladder and urethra using an endoscope	300	272	$315.13	$205.66
50590 Shock wave crushing of kidney stones	229	161	$854.93	$540.81
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	229	65	$96.76	$69.47
51798 Ultrasound measurement of bladder capacity after voiding	199	173	$21.99	$9.17
51741 Electronic assessment of bladder emptying	177	162	$20.77	$13.05
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	114	27	$400.00	$168.06
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	110	37	$78.25	$49.08
76775 Limited ultrasound scan behind abdominal cavity	93	90	$87.60	$55.14
J0696 Injection, ceftriaxone sodium, per 250 mg	76	19	$1.00	$0.54
52332 Insertion of stent in urinary duct (ureter) using an endoscope	73	52	$240.27	$93.40
76872 Ultrasound scan of pelvic region through rectum	55	54	$258.59	$120.88
52281 Dilation of bladder canal (urethra) using an endoscope	47	25	$497.78	$310.60
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	46	44	$149.24	$99.84
55700 Biopsy of prostate gland	44	44	$388.06	$237.76
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	43	11	$25.78	$13.41
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver	41	41	$233.28	$82.63
64581 Incision to insert sacral nerve neurostimulator electrodes	40	40	$953.59	$641.18
95972 Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming	38	38	$59.59	$40.31
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	37	37	$309.73	$201.26
64561 Insertion of sacral nerve neurostimulator electrode array	37	36	$550.35	$443.89
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	35	27	$47.35	$29.39
52005 Insertion of tube into ureter using an endoscope through bladder area	29	29	$177.57	$96.13
52281 Dilation of bladder canal (urethra) using an endoscope	28	24	$229.06	$126.00
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	22	20	$280.19	$164.65
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	16	16	$1135.75	$709.36
52356 Crushing of stone of ureter with insertion of stent using an endoscope	15	15	$625.73	$323.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	1,778	910	$5.00	$2.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,652	891	$108.18	$103.71
52000 Diagnostic exam of bladder and urethra using an endoscope	342	316	$167.99	$165.45
74420 Imaging of urinary tract	308	260	$24.45	$22.40
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	277	84	$74.29	$71.19
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	204	35	$400.00	$221.29
50590 Shock wave crushing of kidney stones	174	137	$593.78	$556.05
51798 Ultrasound measurement of bladder capacity after voiding	141	130	$14.72	$9.31
51741 Electronic assessment of bladder emptying	134	126	$15.43	$12.72
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	131	43	$61.84	$51.30
76775 Limited ultrasound scan behind abdominal cavity	91	90	$59.17	$55.86
76872 Ultrasound scan of pelvic region through rectum	75	73	$93.79	$92.85
52332 Insertion of stent in urinary duct (ureter) using an endoscope	72	60	$168.06	$100.08
55700 Biopsy of prostate gland	71	70	$243.38	$235.72
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	53	53	$747.19	$721.97
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	45	37	$28.99	$28.33
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	43	43	$254.30	$210.04
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	43	43	$205.75	$201.11
52281 Dilation of bladder canal (urethra) using an endoscope	42	27	$274.99	$267.30
64561 Insertion of sacral nerve neurostimulator electrode array	39	38	$570.76	$438.43
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	30	29	$148.97	$137.01
99442 Telephone medical discussion with physician, 11-20 minutes	28	21	$33.61	$33.65
52005 Insertion of tube into ureter using an endoscope through bladder area	27	27	$185.87	$89.84
95972 Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming	27	25	$42.83	$41.56
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver	25	25	$162.66	$82.70
99443 Telephone medical discussion with physician, 21-30 minutes	25	24	$41.60	$41.66
J0696 Injection, ceftriaxone sodium, per 250 mg	24	23	$25.00	$0.57
64581 Incision to insert sacral nerve neurostimulator electrodes	24	24	$680.23	$667.05
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	23	22	$107.26	$101.32
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	22	22	$69.00	$64.41
52281 Dilation of bladder canal (urethra) using an endoscope	19	18	$152.92	$127.89
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	17	17	$22.65	$21.04
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	14	14	$306.28	$293.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	2,314	1,022	$5.00	$2.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	2,169	1,038	$105.24	$101.60
52000 Diagnostic exam of bladder and urethra using an endoscope	456	407	$159.89	$156.18
51798 Ultrasound measurement of bladder capacity after voiding	374	322	$14.68	$11.37
51741 Electronic assessment of bladder emptying	353	305	$15.36	$8.86
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	251	251	$67.25	$55.58
74420 Imaging of urinary tract	243	208	$19.35	$17.53
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	209	30	$400.00	$220.28
50590 Shock wave crushing of kidney stones	188	140	$594.11	$549.28
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	188	65	$74.05	$70.00
76775 Limited ultrasound scan behind abdominal cavity	130	128	$55.29	$54.83
76872 Ultrasound scan of pelvic region through rectum	100	97	$92.80	$88.95
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	96	25	$69.71	$60.61
55700 Biopsy of prostate gland	89	87	$244.82	$235.14
52281 Dilation of bladder canal (urethra) using an endoscope	77	34	$258.34	$256.24
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	73	73	$204.86	$196.63
52332 Insertion of stent in urinary duct (ureter) using an endoscope	72	55	$211.37	$101.86
51797 Insertion of device into abdomen with pressure and urine flow rate study	50	49	$131.00	$129.02
51729 Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies	50	49	$339.00	$335.36
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	46	31	$29.61	$27.83
52005 Insertion of tube into ureter using an endoscope through bladder area	45	45	$164.55	$113.00
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	38	36	$139.30	$138.19
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	36	36	$317.83	$230.58
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	35	29	$102.79	$101.41
J0696 Injection, ceftriaxone sodium, per 250 mg	32	31	$25.00	$0.57
52281 Dilation of bladder canal (urethra) using an endoscope	31	27	$156.49	$144.18
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	25	25	$229.85	$227.14
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	21	21	$733.35	$725.93
64590 Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver	16	16	$165.42	$108.61
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	15	15	$300.48	$258.36
95972 Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming	14	14	$42.59	$41.13
52356 Crushing of stone of ureter with insertion of stent using an endoscope	14	13	$435.89	$357.22
52224 Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope	13	11	$206.80	$182.33
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	13	12	$385.42	$327.31
64561 Insertion of sacral nerve neurostimulator electrode array	12	12	$383.55	$326.21
64581 Incision to insert sacral nerve neurostimulator electrodes	11	11	$666.35	$658.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	2,042	947	$5.39	$2.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,862	960	$103.53	$98.42
52000 Diagnostic exam of bladder and urethra using an endoscope	453	399	$156.81	$149.87
74420 Imaging of urinary tract	293	251	$18.26	$16.48
76000 Imaging guidance for procedure, 60 minutes or less	240	208	$43.49	$8.28
51741 Electronic assessment of bladder emptying	171	143	$15.19	$14.36
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	166	30	$400.00	$214.94
50590 Shock wave crushing of kidney stones	155	115	$573.06	$529.07
51798 Ultrasound measurement of bladder capacity after voiding	151	128	$16.98	$13.84
76775 Limited ultrasound scan behind abdominal cavity	125	123	$55.07	$52.84
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	94	38	$70.53	$68.50
76872 Ultrasound scan of pelvic region through rectum	87	86	$90.75	$84.46
55700 Biopsy of prostate gland	81	80	$240.70	$226.77
52332 Insertion of stent in urinary duct (ureter) using an endoscope	71	60	$157.56	$96.00
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	71	12	$23.72	$18.44
52442 Insertion of implant in urethra within prostate gland using an endoscope, each additional implant	64	17	$60.78	$58.36
52281 Dilation of bladder canal (urethra) using an endoscope	57	34	$261.41	$246.21
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	53	49	$138.10	$133.48
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	51	51	$757.22	$685.70
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	49	32	$29.65	$27.41
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	46	46	$198.71	$191.91
53621 Dilation of narrowing of bladder canal (urethra), male	46	14	$108.59	$96.45
51700 Simple bladder irrigation and/or instillation	44	12	$68.38	$67.04
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	43	28	$102.04	$98.11
52005 Insertion of tube into ureter using an endoscope through bladder area	33	32	$136.16	$127.67
J0696 Injection, ceftriaxone sodium, per 250 mg	28	25	$24.46	$0.61
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	19	18	$201.30	$190.82
57288 Creation of sling around bladder canal (urethra) to control leakage	18	17	$696.50	$663.28
52441 Insertion of implant in urethra within prostate gland using an endoscope, 1 implant	17	17	$228.03	$219.38
52281 Dilation of bladder canal (urethra) using an endoscope	16	16	$165.39	$141.47
52344 Endoscope of the bladder, urethra and ureter to treat a stricture of ureter	14	14	$365.10	$357.04
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	12	$132.63	$121.33
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	13	12	$19.15	$18.73
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	12	11	$233.38	$226.66
52224 Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope	12	11	$205.66	$197.39
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	11	11	$304.81	$279.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	1,774	889	$5.29	$2.97
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,105	718	$104.32	$99.87
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	407	350	$141.50	$134.10
52000 Diagnostic exam of bladder and urethra using an endoscope	367	321	$157.74	$150.55
74420 Imaging of urinary tract	209	187	$18.17	$16.72
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	158	25	$23.82	$23.17
50590 Shock wave crushing of kidney stones	120	99	$610.68	$546.79
51798 Ultrasound measurement of bladder capacity after voiding	107	91	$17.74	$16.81
76000 Imaging guidance for procedure, 60 minutes or less	101	95	$44.31	$8.39
99231 Follow-up hospital inpatient care per day, typically 15 minutes	93	40	$38.39	$37.78
51741 Electronic assessment of bladder emptying	91	78	$15.31	$14.35
99213 Established patient office or other outpatient visit, typically 15 minutes	80	77	$70.66	$68.34
76872 Ultrasound scan of pelvic region through rectum	78	73	$89.61	$85.06
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	74	15	$432.43	$208.75
55700 Biopsy of prostate gland	70	66	$240.93	$230.66
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	64	64	$204.34	$192.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	62	$41.06	$40.38
53621 Dilation of narrowing of bladder canal (urethra), male	61	12	$108.00	$101.28
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	51	22	$70.52	$69.39
76770 Complete ultrasound scan behind abdominal cavity	51	51	$106.12	$103.52
52332 Insertion of stent in urinary duct (ureter) using an endoscope	50	46	$259.28	$110.10
52281 Dilation of bladder canal (urethra) using an endoscope	45	40	$259.11	$245.60
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	45	45	$857.66	$796.09
76775 Limited ultrasound scan behind abdominal cavity	42	42	$55.69	$52.88
52005 Insertion of tube into ureter using an endoscope through bladder area	31	31	$187.71	$118.42
J0696 Injection, ceftriaxone sodium, per 250 mg	28	23	$10.00	$0.65
J2550 Injection, promethazine hcl, up to 50 mg	27	19	$10.00	$2.12
J2175 Injection, meperidine hydrochloride, per 100 mg	26	19	$24.23	$4.76
99221 Initial hospital inpatient care per day, typically 30 minutes	23	23	$98.84	$97.26
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	22	17	$29.94	$29.46
53850 Destruction of prostate tissue using microwave induced heat	18	18	$2015.48	$1704.22
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	16	14	$246.61	$218.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$111.98	$101.46

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License OK 16231

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

100137260A (OK)

Hospital & Practice Group Affiliations

Southern Oklahoma Urology, Inc

1414 Arlington St, Ada, OK 748202694

Phone: 5803320112

Chickasaw Nation Division Of Health

1921 Stonecipher Dr, Ada, OK 748203439

Phone: 5804363980

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Mark Leu , PA-C

Physician Assistant - Medical

NPI 1376538744

Physician Assistant (Certified)

Dr. Phillip Fuller , MD

Urology

NPI 1871720300

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active August 11, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location August 11, 2010

Registered at 1414 ARLINGTON ST, SUITE 2300, ADA, OK 748202643 (Tel: 5803320112)

📍

Updated Business Mailing Address August 11, 2010

Registered at 1414 ARLINGTON ST, SUITE 2300, ADA, OK 748202643 (Tel: 5803320112)

👤

Provider Name / Credentials Updated August 11, 2010

Recorded as GLEN DIACON, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2010

Specialist (License #16231 in OK)

🟢

Initial NPI Registration & Enumeration September 13, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588659957

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 13, 2005

Last Update: August 11, 2010

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1414 Arlington St, Suite 2300

Ada, OK 748202643

Phone: 5803320112

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.