Medicaid Provider Spending

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

DUKE UNIVERSITY HEALTH SYSTEM, INC.

NPI: 1376574798 · DURHAM, NC 27704 · Cardiovascular Disease Physician · NPI assigned 07/05/2006

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

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

$7.61M
Total Medicaid Paid
128,963
Total Claims
91,647
Beneficiaries
32
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSMITH, JOHN (VP, FINANCE)
Parent OrganizationDUKE UNIVERSITY HEALTH SYSTEM, INC.
NPI Enumeration Date07/05/2006

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 RALEIGH NC $7.84M
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 6,170 $226K
2019 18,530 $1.17M
2020 14,182 $950K
2021 16,319 $1.08M
2022 16,435 $1.06M
2023 23,610 $1.29M
2024 33,717 $1.84M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 35,721 30,873 $2.68M
99284 Emergency department visit for the evaluation and management, high severity 34,574 31,096 $2.50M
99233 Prolong inpt eval add15 m 24,849 9,617 $1.08M
99232 Subsequent hospital care, per day, moderate complexity 17,345 6,690 $584K
99223 Prolong inpt eval add15 m 3,244 2,924 $262K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,487 3,414 $196K
99283 Emergency department visit for the evaluation and management, moderate severity 2,585 2,344 $105K
99239 Hospital discharge day management, more than 30 minutes 1,232 1,092 $58K
99238 Hospital discharge day management, 30 minutes or less 858 769 $43K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 835 574 $21K
90837 Psychotherapy, 53 minutes with patient 220 147 $17K
99282 Emergency department visit for the evaluation and management, low to moderate severity 394 341 $13K
99460 113 88 $8K
99215 Prolong outpt/office vis 108 80 $8K
99222 Initial hospital care, per day, moderate complexity 51 41 $5K
D0160 71 55 $4K
90792 Psychiatric diagnostic evaluation with medical services 39 25 $4K
96127 1,175 602 $3K
99443 80 71 $3K
99255 16 13 $2K
90832 Psychotherapy, 30 minutes with patient 59 26 $2K
99199 Unlisted special service, procedure or report 401 401 $2K
90791 Psychiatric diagnostic evaluation 39 25 $2K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 17 13 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 30 26 $1K
99220 26 26 $891.10
90834 Psychotherapy, 45 minutes with patient 18 13 $764.70
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 27 26 $748.62
99231 Subsequent hospital care, per day, straightforward or low complexity 70 12 $442.08
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) 223 198 $192.98
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 35 12 $123.39
99497 21 13 $106.42