Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

DUKE UNIVERSITY HEALTH SYSTEM INC

NPI: 1013916352 · RALEIGH, NC 27609 · General Acute Care Hospital · NPI assigned 07/19/2005

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official SMITH, JOHN controls 20+ related entities in our dataset. Read more

$7.84M
Total Medicaid Paid
174,391
Total Claims
146,652
Beneficiaries
105
Codes Billed
2018-01
First Month
2024-05
Last Month

Provider Details

Authorized OfficialSMITH, JOHN (VP FINANCE)
NPI Enumeration Date07/19/2005

Related Entities

Other providers sharing the same authorized official: SMITH, JOHN

ProviderCityStateTotal Paid
PRESTIGE HEALTHCARE RESOURCES INC. BLADENSBURG MD $55.74M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $44.35M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $11.62M
PROACT DENTAL, INC. BIRMINGHAM AL $9.47M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $8.33M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $7.61M
WISHON RADIOLOGICAL MEDICAL GROUP, INC. FRESNO CA $5.11M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $5.01M
DUKE UNIVERSITY HEALTH SYSTEM, INC. RALEIGH NC $4.15M
LIGHTHOUSE SYSTEMS, LLC PHARR TX $3.54M
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $1.59M
OLD SCHOOL LLC LAKEWOOD OH $800K
GATEWAY MEDICAL GROUP LC OKEECHOBEE FL $447K
TRIANGLE GERIATRIC AND MEMORY CLINIC, PLLC CARY NC $437K
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $289K
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $118K
ASSOCIATED HEALTH SERVICES, INC. DURHAM NC $102K
DUKE HEALTH INTEGRATED PRACTICE, INC. DURHAM NC $64K
DUKE UNIVERSITY HEALTH SYSTEM, INC. DURHAM NC $49K
WOMEN'S IMAGING SPECIALISTS IN HEALTHCARE FRESNO CA $36K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 17,029 $949K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 9,370 8,369 $2.40M
99284 Emergency department visit for the evaluation and management, high severity 10,330 9,364 $2.01M
99283 Emergency department visit for the evaluation and management, moderate severity 13,306 12,356 $1.58M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 14,586 11,262 $372K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 30,711 24,791 $200K
80053 Comprehensive metabolic panel 22,078 17,515 $162K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 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 1,154 1,054 $103K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 3,678 3,123 $88K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 1,235 715 $84K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,119 788 $63K
36415 Collection of venous blood by venipuncture 27,478 23,981 $61K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 1,163 1,053 $59K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 815 755 $53K
96375 Therapeutic injection; each additional sequential IV push 674 560 $42K
36591 1,332 689 $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 1,134 1,040 $34K
0002A 540 516 $32K
96361 Intravenous infusion, hydration; each additional hour 1,390 1,164 $32K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 985 901 $28K
0001A 501 490 $27K
J7030 Infusion, normal saline solution , 1000 cc 2,385 2,028 $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 535 493 $14K
99281 Emergency department visit for the evaluation and management, self-limited or minor 313 301 $13K
83690 1,999 1,749 $13K
80061 Lipid panel 679 637 $12K
81025 1,565 1,400 $12K
95810 Polysomnography; sleep staging with 4 or more additional parameters 26 24 $11K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 195 187 $9K
83735 1,600 1,144 $9K
80048 Basic metabolic panel (calcium, ionized) 1,343 1,154 $9K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 53 48 $8K
0072A 121 109 $8K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 261 224 $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 193 184 $7K
71046 Radiologic examination, chest; 2 views 203 177 $7K
87086 Culture, bacterial; quantitative colony count, urine 882 810 $7K
82728 694 619 $7K
85027 884 711 $6K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 167 147 $6K
81001 2,098 1,869 $6K
J3490 Unclassified drugs 1,532 1,004 $5K
82378 333 211 $5K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 147 129 $5K
0071A 111 94 $5K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 147 129 $5K
86780 271 232 $5K
84443 Thyroid stimulating hormone (TSH) 258 226 $5K
87081 493 488 $4K
83550 452 398 $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 30 26 $3K
J7050 Infusion, normal saline solution, 250 cc 706 376 $3K
83540 520 449 $3K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 39 39 $3K
84484 287 210 $2K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 26 25 $2K
83615 298 227 $2K
87631 28 24 $2K
83036 Hemoglobin; glycosylated (A1C) 113 104 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 1,346 1,192 $2K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 47 39 $1K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 42 26 $1K
87634 14 12 $1K
85730 239 219 $1K
86850 74 63 $1K
0004A 25 20 $1K
85610 295 269 $942.76
81003 377 335 $836.96
84439 86 65 $815.53
85046 187 172 $795.79
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 77 61 $702.52
J7120 Ringers lactate infusion, up to 1000 cc 106 90 $651.28
84403 65 49 $641.82
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 13 12 $555.84
84153 80 63 $539.39
71045 Radiologic examination, chest; single view 12 12 $450.09
82784 21 15 $312.44
82607 14 14 $293.68
86803 15 15 $280.20
86901 73 62 $273.22
86900 73 62 $273.22
82553 29 25 $208.65
J2704 Injection, propofol, 10 mg 108 74 $200.40
82248 44 36 $179.24
82950 28 24 $178.62
82550 30 26 $152.32
84165 14 14 $128.44
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 16 16 $112.48
83521 18 12 $92.11
82040 16 12 $74.77
J2405 Injection, ondansetron hydrochloride, per 1 mg 161 132 $64.16
J3010 Injection, fentanyl citrate, 0.1 mg 27 27 $50.89
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 26 25 $49.61
J0696 Injection, ceftriaxone sodium, per 250 mg 61 59 $39.94
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 43 42 $24.22
J2270 Injection, morphine sulfate, up to 10 mg 17 15 $23.78
J1100 Injection, dexamethasone sodium phosphate, 1 mg 112 106 $23.58
84460 38 24 $1.44
D2930 Prefabricated stainless steel crown - primary tooth 12 12 $1.33
84450 38 24 $1.28
91307 269 234 $0.00
84075 16 12 $0.00
91300 1,477 1,342 $0.00
84155 16 12 $0.00
82247 16 12 $0.00