Hospital
Duke University Health System, INC.
Duke University Health System, INC. was paid $11.62M by Medicaid between Jan 2018 and Dec 2024, across 93 billing codes. Its largest line is 99285, emergency room visit (most serious) — 41% of everything it billed.
33Billing provider infoDUKE UNIVERSITY HEALTH SYSTEM, INC.
DURHAM, NC 27704
DURHAM, NC 27704
33aNPI1871592113assigned 07/19/2005
33bProvider typeGeneral Acute Care Hospital
28Total paid$11.62M
24GClaims253,377
24DCodes billed93
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in North Carolina
Rank by total paid#46 of 92
Median peer was paid$11.47M
This provider vs. median1.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official SMITH, JOHN controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | 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 | |
| 2024incomplete | 48,592 | $2.86M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 41% | 19,453 | 17,043 | $4.73M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 24% | 25,130 | 23,771 | $2.81M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 18% | 13,133 | 12,353 | $2.04M |
| 80053 | Comprehensive metabolic panel | 2.7% | 35,683 | 31,697 | $317K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.8% | 29,784 | 26,492 | $210K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 1.7% | 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 | 1.5% | 1,715 | 1,658 | $172K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 4,704 | 4,396 | $101K |
| 36415 | Collection of venous blood by venipuncture | <1% | 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 | <1% | 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% | 1,862 | 1,310 | $84K |
| 71045 | Radiologic examination, chest; single view | <1% | 1,977 | 1,809 | $63K |
81 more codes
| 0002A | <1% | 999 | $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% | 1,663 | $56K |
| 0001A | <1% | 1,035 | $52K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 2,209 | $40K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 1,331 | $39K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 606 | $38K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 1,820 | $35K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 3,418 | $35K |
| 83690 | <1% | 4,125 | $27K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 984 | $25K |
| 87631 | <1% | 342 | $25K | |
| 84484 | <1% | 3,545 | $23K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,555 | $22K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 41 | $22K |
| 81025 | <1% | 3,093 | $21K | |
| 82553 | <1% | 2,379 | $16K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 429 | $16K |
| J3490 | Unclassified drugs | <1% | 4,027 | $13K |
| 81001 | <1% | 4,532 | $13K | |
| 85730 | <1% | 2,654 | $12K | |
| 80061 | Lipid panel | <1% | 621 | $11K |
| 84702 | <1% | 1,037 | $11K | |
| 82550 | <1% | 2,498 | $10K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 350 | $10K |
| 85027 | <1% | 1,868 | $9K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 1,652 | $8K |
| 85610 | <1% | 2,747 | $8K | |
| 83655 | <1% | 335 | $7K | |
| 59025 | Fetal non-stress test | <1% | 173 | $6K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 163 | $5K |
| 0072A | <1% | 84 | $5K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 247 | $5K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 24 | $4K |
| 83525 | <1% | 244 | $3K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 359 | $3K |
| 86141 | <1% | 213 | $3K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 89 | $3K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 89 | $3K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 82 | $3K |
| 0071A | <1% | 69 | $3K | |
| 83735 | <1% | 422 | $2K | |
| 0004A | <1% | 41 | $2K | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 316 | $2K |
| 81003 | <1% | 615 | $1K | |
| 82043 | <1% | 175 | $1K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 172 | $1K |
| 84550 | <1% | 194 | $1K | |
| 87522 | Neg quan hep c or qual rna | <1% | 25 | $1K |
| 83880 | <1% | 39 | $955.43 | |
| 83718 | <1% | 74 | $893.19 | |
| 93990 | <1% | 34 | $814.40 | |
| 97602 | <1% | 31 | $717.94 | |
| 90870 | <1% | 26 | $698.04 | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 93 | $663.41 |
| 82465 | <1% | 74 | $523.16 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 271 | $508.88 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 908 | $477.70 |
| 84460 | <1% | 46 | $325.38 | |
| 86780 | <1% | 13 | $297.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 28 | $246.95 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 14 | $192.43 |
| 80076 | <1% | 12 | $119.88 | |
| 83550 | <1% | 27 | $111.30 | |
| 83540 | <1% | 27 | $83.31 | |
| J1644 | Injection, heparin sodium, per 1000 units | <1% | 195 | $65.48 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 283 | $65.22 |
| 82948 | <1% | 22 | $60.33 | |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | <1% | 24 | $58.02 |
| J2704 | Injection, propofol, 10 mg | <1% | 101 | $32.87 |
| 80047 | <1% | 30 | $31.29 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 60 | $27.34 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 172 | $26.55 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | <1% | 41 | $17.12 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 116 | $16.09 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 150 | $5.89 |
| 85014 | <1% | 24 | $2.95 | |
| 84132 | <1% | 29 | $2.84 | |
| 82435 | <1% | 26 | $1.81 | |
| 84295 | <1% | 26 | $1.65 | |
| 84520 | <1% | 26 | $0.94 | |
| 91300 | <1% | 2,480 | $0.03 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSMITH, JOHN (VP FINANCE)
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.