Hospital
Duke University Health System INC
Duke University Health System INC was paid $7.84M by Medicaid between Jan 2018 and May 2024, across 105 billing codes. Its largest line is 99285, emergency room visit (most serious) — 31% of everything it billed.
33Billing provider infoDUKE UNIVERSITY HEALTH SYSTEM INC
RALEIGH, NC 27609
RALEIGH, NC 27609
33aNPI1013916352assigned 07/19/2005
33bProvider typeGeneral Acute Care Hospital
28Total paid$7.84M
24GClaims174,391
24DCodes billed105
24AFirst – last monthJan 2018 – May 2024
Compared with peers
Next to other General Acute Care Hospital providers in North Carolina
Rank by total paid#58 of 92
Median peer was paid$11.47M
This provider vs. median0.7×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official SMITH, JOHN controls 20+ related entities in our dataset. Read more
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 | 25,229 | $1.04M | |
| 2019 | 19,292 | $783K | |
| 2020 | 14,716 | $421K | |
| 2021 | 28,460 | $1.12M | |
| 2022 | 35,918 | $1.83M | |
| 2023 | 33,747 | $1.70M | |
| 2024incomplete | 17,029 | $949K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 31% | 9,370 | 8,369 | $2.40M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 26% | 10,330 | 9,364 | $2.01M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 20% | 13,306 | 12,356 | $1.58M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.7% | 14,586 | 11,262 | $372K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 2.5% | 30,711 | 24,791 | $200K |
| 80053 | Comprehensive metabolic panel | 2.1% | 22,078 | 17,515 | $162K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 1.4% | 2,912 | 2,576 | $108K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 1.3% | 1,154 | 1,054 | $103K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 1.1% | 3,678 | 3,123 | $88K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 1.1% | 1,235 | 715 | $84K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 1,119 | 788 | $63K |
| 36415 | Collection of venous blood by venipuncture | <1% | 27,478 | 23,981 | $61K |
93 more codes
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 1,163 | $59K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 815 | $53K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 674 | $42K |
| 36591 | <1% | 1,332 | $41K | |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 1,134 | $34K |
| 0002A | <1% | 540 | $32K | |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 1,390 | $32K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 985 | $28K |
| 0001A | <1% | 501 | $27K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 2,385 | $17K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 535 | $14K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 313 | $13K |
| 83690 | <1% | 1,999 | $13K | |
| 80061 | Lipid panel | <1% | 679 | $12K |
| 81025 | <1% | 1,565 | $12K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 26 | $11K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 195 | $9K |
| 83735 | <1% | 1,600 | $9K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 1,343 | $9K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 53 | $8K |
| 0072A | <1% | 121 | $8K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 261 | $8K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | <1% | 193 | $7K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 203 | $7K |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 882 | $7K |
| 82728 | <1% | 694 | $7K | |
| 85027 | <1% | 884 | $6K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 167 | $6K |
| 81001 | <1% | 2,098 | $6K | |
| J3490 | Unclassified drugs | <1% | 1,532 | $5K |
| 82378 | <1% | 333 | $5K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 147 | $5K |
| 0071A | <1% | 111 | $5K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 147 | $5K |
| 86780 | <1% | 271 | $5K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 258 | $5K |
| 87081 | <1% | 493 | $4K | |
| 83550 | <1% | 452 | $3K | |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | <1% | 30 | $3K |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 706 | $3K |
| 83540 | <1% | 520 | $3K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 39 | $3K |
| 84484 | <1% | 287 | $2K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 26 | $2K |
| 83615 | <1% | 298 | $2K | |
| 87631 | <1% | 28 | $2K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 113 | $2K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,346 | $2K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 47 | $1K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 42 | $1K |
| 87634 | <1% | 14 | $1K | |
| 85730 | <1% | 239 | $1K | |
| 86850 | <1% | 74 | $1K | |
| 0004A | <1% | 25 | $1K | |
| 85610 | <1% | 295 | $942.76 | |
| 81003 | <1% | 377 | $836.96 | |
| 84439 | <1% | 86 | $815.53 | |
| 85046 | <1% | 187 | $795.79 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 77 | $702.52 |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 106 | $651.28 |
| 84403 | <1% | 65 | $641.82 | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 13 | $555.84 |
| 84153 | <1% | 80 | $539.39 | |
| 71045 | Radiologic examination, chest; single view | <1% | 12 | $450.09 |
| 82784 | <1% | 21 | $312.44 | |
| 82607 | <1% | 14 | $293.68 | |
| 86803 | <1% | 15 | $280.20 | |
| 86901 | <1% | 73 | $273.22 | |
| 86900 | <1% | 73 | $273.22 | |
| 82553 | <1% | 29 | $208.65 | |
| J2704 | Injection, propofol, 10 mg | <1% | 108 | $200.40 |
| 82248 | <1% | 44 | $179.24 | |
| 82950 | <1% | 28 | $178.62 | |
| 82550 | <1% | 30 | $152.32 | |
| 84165 | <1% | 14 | $128.44 | |
| J0134 | Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg | <1% | 16 | $112.48 |
| 83521 | <1% | 18 | $92.11 | |
| 82040 | <1% | 16 | $74.77 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 161 | $64.16 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 27 | $50.89 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 26 | $49.61 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 61 | $39.94 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 43 | $24.22 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 17 | $23.78 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 112 | $23.58 |
| 84460 | <1% | 38 | $1.44 | |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 12 | $1.33 |
| 84450 | <1% | 38 | $1.28 | |
| 91307 | 0% | 269 | $0.00 | |
| 84075 | 0% | 16 | $0.00 | |
| 91300 | 0% | 1,477 | $0.00 | |
| 84155 | 0% | 16 | $0.00 | |
| 82247 | 0% | 16 | $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 officialSMITH, JOHN (VP FINANCE)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.