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 Health Integrated Practice, Inc. (NPI 1205553369)

Duke Health Integrated Practice, Inc. is a general practice physician provider located in Durham, North Carolina. This profile covers 0 Medicare and 379 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Duke Health Integrated Practice, Inc.
Address	40 Duke Medicine Cir
City	Durham
State	NC
ZIP	27710
Taxonomy	General Practice Physician
NPI Enumerated	October 20, 2022

Payer Source	Total Paid
Medicaid	$36.3M
Medicare	$0

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

379 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	100,730	$70	$6.5M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	982,880	$10	$5.9M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	45,940	$50	$2.5M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	27,360	$80	$2.1M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	30,790	$40	$1.3M
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.	12,760	$90	$1.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,560	$90	$961.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	17,600	$50	$932.6K
T1017	Targeted case management, each 15 minutes	4,440	$190	$857.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,000	$90	$837K

Showing 1–10 of 379

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 Health Integrated Practice, Inc. — 10 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

379 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.	154	330	6,130	$130	$2.7M
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.	204	320	6,160	$120	$2.1M
81229	The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by…	7	10	680	$480	$1.9M
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.	75	280	2,690	$130	$1.6M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	12	20	2,430	$300	$1.5M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	6	10	1,880	$290	$1.4M
T1017	Targeted case management, each 15 minutes	49	220	1,700	$150	$1.3M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	425	640	4,280	$60	$983.2K
D8670	N/A	187	190	2,510	$90	$774.4K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	12	20	3,950	$100	$740.3K

Showing 1–10 of 379

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
Balboa Nephrology Medical Group, Inc.	CA	Nephrology Physician	$0	$25.9M
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	General Acute Care Hospital	$0	$7.9M
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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jonathan Cook	NC	Dermatology Physician	$1.6M	$0
Tywana Donaldson	NC	Nurse Practitioner	$1.4M	$0
Pretesh Patel	NC	Radiation Oncology Physician	$668.8K	$0
Pedro Vargas	NC	Diagnostic Radiology Physician	$439.5K	$0
Michael Rehorn	NC	Student in an Organized Health Care Education/Training Program	$369.4K	$0
Christopher Brown	NC	Orthopaedic Surgery Physician	$360.8K	$0
Sunit Vekaria	NC	Diagnostic Radiology Physician	$358.3K	$0
Priyatham Mettu	NC	Ophthalmology Physician	$332.6K	$0
Christopher Boehlke	NC	Ophthalmology Physician	$314.3K	$0
Leon Herndon	NC	Ophthalmology Physician	$264K	$0

Duke Health Integrated Practice, Inc. — Billing Profile & Reimbursement Data

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Duke Health Integrated Practice, 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

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