Medicaid Provider Spending

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

DUKE UNIVERSITY HEALTH SYSTEM, INC.

NPI: 1871592113 · DURHAM, NC 27704 · 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

$11.62M
Total Medicaid Paid
253,377
Total Claims
223,719
Beneficiaries
93
Codes Billed
2018-01
First Month
2024-12
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
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 $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 49,398 $1.71M
2019 37,783 $1.56M
2020 20,978 $940K
2021 28,092 $1.23M
2022 28,246 $1.31M
2023 40,288 $2.01M
2024 48,592 $2.86M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 19,453 17,043 $4.73M
99283 Emergency department visit for the evaluation and management, moderate severity 25,130 23,771 $2.81M
99284 Emergency department visit for the evaluation and management, high severity 13,133 12,353 $2.04M
80053 Comprehensive metabolic panel 35,683 31,697 $317K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 29,784 26,492 $210K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 11,817 9,575 $194K
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 1,715 1,658 $172K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 4,704 4,396 $101K
36415 Collection of venous blood by venipuncture 43,833 39,641 $97K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 3,073 2,181 $84K
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 1,862 1,310 $84K
71045 Radiologic examination, chest; single view 1,977 1,809 $63K
0002A 999 912 $56K
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 1,663 1,604 $56K
0001A 1,035 932 $52K
71046 Radiologic examination, chest; 2 views 2,209 2,092 $40K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,331 985 $39K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 606 578 $38K
96361 Intravenous infusion, hydration; each additional hour 1,820 1,676 $35K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 3,418 2,918 $35K
83690 4,125 3,790 $27K
96375 Therapeutic injection; each additional sequential IV push 984 908 $25K
87631 342 308 $25K
84484 3,545 2,713 $23K
83036 Hemoglobin; glycosylated (A1C) 1,555 1,478 $22K
74177 Computed tomography, abdomen and pelvis; with contrast material 41 37 $22K
81025 3,093 2,923 $21K
82553 2,379 1,976 $16K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 429 424 $16K
J3490 Unclassified drugs 4,027 1,104 $13K
81001 4,532 4,200 $13K
85730 2,654 2,421 $12K
80061 Lipid panel 621 594 $11K
84702 1,037 942 $11K
82550 2,498 2,069 $10K
99281 Emergency department visit for the evaluation and management, self-limited or minor 350 337 $10K
85027 1,868 1,594 $9K
J7030 Infusion, normal saline solution , 1000 cc 1,652 1,454 $8K
85610 2,747 2,516 $8K
83655 335 329 $7K
59025 Fetal non-stress test 173 152 $6K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 163 127 $5K
0072A 84 78 $5K
84443 Thyroid stimulating hormone (TSH) 247 241 $5K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 24 24 $4K
83525 244 242 $3K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 359 274 $3K
86141 213 213 $3K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 89 79 $3K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 89 79 $3K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 82 79 $3K
0071A 69 56 $3K
83735 422 311 $2K
0004A 41 39 $2K
J7120 Ringers lactate infusion, up to 1000 cc 316 261 $2K
81003 615 580 $1K
82043 175 175 $1K
87086 Culture, bacterial; quantitative colony count, urine 172 160 $1K
84550 194 194 $1K
87522 Neg quan hep c or qual rna 25 25 $1K
83880 39 36 $955.43
83718 74 68 $893.19
93990 34 27 $814.40
97602 31 15 $717.94
90870 26 12 $698.04
80048 Basic metabolic panel (calcium, ionized) 93 74 $663.41
82465 74 68 $523.16
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 271 251 $508.88
J1885 Injection, ketorolac tromethamine, per 15 mg 908 829 $477.70
84460 46 38 $325.38
86780 13 13 $297.00
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 28 25 $246.95
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 14 13 $192.43
80076 12 12 $119.88
83550 27 24 $111.30
83540 27 24 $83.31
J1644 Injection, heparin sodium, per 1000 units 195 84 $65.48
J2405 Injection, ondansetron hydrochloride, per 1 mg 283 255 $65.22
82948 22 15 $60.33
J0330 Injection, succinylcholine chloride, up to 20 mg 24 12 $58.02
J2704 Injection, propofol, 10 mg 101 78 $32.87
80047 30 24 $31.29
J0690 Injection, cefazolin sodium, 500 mg 60 39 $27.34
J3010 Injection, fentanyl citrate, 0.1 mg 172 98 $26.55
J2795 Injection, ropivacaine hydrochloride, 1 mg 41 25 $17.12
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 116 54 $16.09
J2250 Injection, midazolam hydrochloride, per 1 mg 150 92 $5.89
85014 24 12 $2.95
84132 29 14 $2.84
82435 26 13 $1.81
84295 26 13 $1.65
84520 26 13 $0.94
91300 2,480 2,220 $0.03