Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. North Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Duke University Health System Inc (NPI 1013916352)

Field	Value
Entity Type	Organization
Organization	Duke University Health System Inc
Address	3400 Wake Forest Rd
City	Raleigh
State	NC
ZIP	27609
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 19, 2005

Payer Source	Total Paid
Medicaid	$7.9M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

105 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	9,370	$260	$2.4M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	10,330	$190	$2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	13,310	$120	$1.6M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	14,590	$30	$379.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	30,710	$10	$215K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	22,080	$10	$154.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,910	$40	$107.7K
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…	1,150	$90	$102.7K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	3,680	$20	$88.3K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	1,240	$70	$84K

Showing 1–10 of 105

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. North Carolina Distribution

Duke University Health System Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	131	330	6,130	$130	$2.7M
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…	70	160	840	$70	$2.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	110	320	6,160	$120	$2.1M
G0483	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…	104	110	1,450	$110	$1.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	91	280	2,690	$130	$1.6M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	291	360	1,830	$40	$819.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	127	190	530	$20	$635.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	126	190	560	$20	$609.8K
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…	108	150	860	$50	$586.6K
0241U	N/A	117	140	1,140	$150	$510.8K

Showing 1–10 of 105

Related Providers

Other providers that share a Tax Identification Number (TIN) with Duke University Health System Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Private Diagnostic Clinic, PLLC	NC	General Practice Physician	$0	$46.5M
Duke University Health System, Inc.	NC	General Acute Care Hospital	$0	$44.4M
Duke Health Integrated Practice, Inc.	NC	General Practice Physician	$0	$36.3M
Duke University Health System, Inc.	NC	General Acute Care Hospital	$0	$11.6M
Duke University Affiliated Physicians, Inc.	NC	Emergency Medicine Physician	$0	$11.6M
Duke University Health System, Inc.	NC	Parenteral & Enteral Nutrition Supplies (DME)	$0	$8.3M
Duke University Health System, Inc.	NC	Internal Medicine Physician	$0	$7.6M
Majda Hadziahmetovic	NC	Ophthalmology Physician	$2.3M	$0
Michael Allingham	NC	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Associated Health Services, Inc.	NC	Ambulatory Surgical Clinic/Center	$1.6M	$102.4K

Nearby Providers

Other providers in the same ZIP code as Duke University Health System Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Arc Of North Carolina	NC	Community/Behavioral Health Agency	$0	$77.5M
Voca Corp Of North Carolina	NC	Community/Behavioral Health Agency	$0	$62.8M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$58.3M
Fastmed Urgent Care PC	NC	Urgent Care Clinic/Center	$0	$40.4M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$29.3M
Carter Clinic, P A	NC	Psychiatry Physician	$0	$19.4M
Professional Healthcare, LLC	NC	Nursing Care Agency	$0	$17.6M
Healing Interventions, Inc	NC	Community/Behavioral Health Agency	$0	$15.3M
Kids First Pediatrics Of Raleigh, PLLC	NC	Pediatrics Physician	$0	$12M
Raleigh Best Medical Supply And Home Health Care Services, LLC	NC	Home Health Agency	$0	$11.9M

Duke University Health System Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References