Medicaid Provider Spending

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

DUKE UNIVERSITY HEALTH SYSTEM, INC.

NPI: 1477584894 · RALEIGH, NC 27609 · Emergency Medical Services (Emergency Medicine) 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

$4.15M
Total Medicaid Paid
64,114
Total Claims
53,646
Beneficiaries
14
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSMITH, JOHN (ASSOCIATE VICE PRESIDENT DUHS)
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
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
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 9,031 $561K
2019 7,834 $497K
2020 5,316 $352K
2021 7,241 $499K
2022 11,704 $772K
2023 11,631 $723K
2024 11,357 $748K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 36,249 32,210 $2.47M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 16,380 14,460 $1.26M
99233 Prolong inpt eval add15 m 4,686 1,851 $178K
99283 Emergency department visit for the evaluation and management, moderate severity 2,288 2,110 $92K
99223 Prolong inpt eval add15 m 731 657 $58K
99232 Subsequent hospital care, per day, moderate complexity 1,570 600 $43K
99282 Emergency department visit for the evaluation and management, low to moderate severity 957 883 $27K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 951 625 $14K
99239 Hospital discharge day management, more than 30 minutes 149 138 $7K
99220 59 44 $4K
90791 Psychiatric diagnostic evaluation 38 30 $3K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 14 14 $2K
99231 Subsequent hospital care, per day, straightforward or low complexity 30 12 $138.88
93000 12 12 $116.24