Medicaid Provider Spending

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

DUKE UNIVERSITY HEALTH SYSTEM, INC.

NPI: 1558392977 · DURHAM, NC 27710 · Internal 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

$289K
Total Medicaid Paid
7,593
Total Claims
5,423
Beneficiaries
31
Codes Billed
2018-01
First Month
2024-11
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
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 $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 601 $25K
2019 857 $47K
2020 412 $17K
2021 1,574 $43K
2022 1,047 $51K
2023 1,094 $38K
2024 2,008 $67K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,368 1,236 $83K
97750 1,984 1,415 $57K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 329 192 $28K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1,230 589 $17K
97164 387 292 $12K
99460 168 160 $12K
J0248 Injection, remdesivir, 1 mg 47 16 $11K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 31 26 $9K
99238 Hospital discharge day management, 30 minutes or less 151 147 $9K
90791 Psychiatric diagnostic evaluation 81 77 $8K
01920 37 36 $5K
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring 26 13 $5K
97530 Therapeutic activities, direct patient contact, each 15 minutes 222 95 $5K
90832 Psychotherapy, 30 minutes with patient 169 97 $4K
00140 55 50 $4K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 206 141 $3K
99215 Prolong outpt/office vis 59 54 $3K
99462 75 67 $2K
97597 194 139 $2K
99253 19 15 $2K
M0222 Intravenous injection, bebtelovimab, includes injection and post administration monitoring 61 44 $1K
99443 59 42 $1K
99221 26 24 $1K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 44 16 $1K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 81 68 $961.80
M0245 Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring 25 12 $940.06
97161 21 12 $828.04
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 39 39 $456.29
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) 360 283 $353.03
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 22 13 $259.05
99442 17 13 $93.84