Loading...
NPI 1932208576 · Chapel Hill, NC · General Acute Care Hospital
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
University Of North Carolina Hospitals At Chapel Hill is a general acute care hospital provider located in Chapel Hill, North Carolina. This profile covers 0 Medicare and 320 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | University Of North Carolina Hospitals At Chapel Hill |
| Address | 101 Manning Dr |
| City | Chapel Hill |
| State | NC |
| ZIP | 27514 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | September 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $50.7M |
| Medicare | $0 |
This provider has no Medicare billing on file and reports $50.7M in lifetime Medicaid revenue, making its billing footprint effectively single‑payer (Medicaid) in the available data. Analysts should treat Medicaid activity as the primary source for competitive and utilization review since Medicare comparisons are not possible for this NPI.
Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 55.4% of this provider's total Medicaid revenue. Those top contributors are G0463 ($12M, 27.1%), 99284 ($6.2M, 14.1%), and 99283 ($6.2M, 14.1%), indicating a small set of codes drives a majority of Medicaid dollars.
The code mix points to a hospital-centered operating model with heavy outpatient clinic and emergency department activity. G0463 (hospital outpatient clinic visit) is the single largest Medicaid revenue line at $12M (27.1%), and ED evaluation and management codes 99284 and 99283 together contribute $12.4M (two 14.1% lines), which signals that outpatient assessments and ED throughput are primary service lines for Medicaid patients.
Competitive standing by code shows dominance for several specialized services: G0463 ranks #3 of 86 in-state (98th percentile) and is described as an extreme outlier, identifying this provider as a top statewide destination for hospital outpatient clinic visits for assessment and management. In contrast, 99284 (rank #87 of 325, 73rd percentile) and 99283 (rank #41 of 316, 87th percentile) are high-volume but more typical in-state for ED E/M work.
Infusion and high-cost drug administration are meaningful revenue drivers and relative outliers. J1745 (infliximab, excludes biosimilar) generates $4.7M (10.7%) and ranks #1 of 6 in-state (100th percentile; notably above typical state volume), while 96365 (initial IV infusion) produces $1M (2.4%) and ranks #1 of 92 (100th percentile; extreme outlier), together signaling concentrated capacity for biologic and infusion services.
The provider reports sizable air-transport and unclassified drug billing lines that suggest breadth beyond core ED/outpatient care. A0431 (rotary wing ambulance) accounts for $2.1M (4.7%) and ranks #11 of 14 in-state (23rd percentile), indicating available rotor-wing transport but not statewide leadership; J3490 (unclassified drugs) shows 143.9K claims and $1.2M (2.6%), ranking #4 of 158 (98th percentile) and reflecting unusually high volumes of miscellaneous drug billing.
Diagnostic testing and imaging volumes are high and contribute meaningful Medicaid revenue, supporting a busy acute-care and outpatient diagnostic operation. U0003 (SARS‑CoV‑2 PCR, high throughput) has 18.3K claims and $1.4M (3.2%), ranking #14 of 158 (92nd percentile); 85025 (CBC) shows 94K claims and $752.2K (1.7%), ranking #15 of 608 (98th percentile); and MRI brain 70551 contributes $696.8K (1.6%), which together indicate robust lab and imaging throughput for the Medicaid population.
This NPI has an established tenure (enumerated 2006-09-21, ~20 years ago), which combined with the concentration in outpatient clinic, ED, infusion, and diagnostic services suggests a long-standing regional acute-care hub. For payer/provider analysts this profile flags the outpatient clinic and ED workflows plus infusion/drug administration as priority areas for utilization management, contracting focus, and competitive benchmarking within North Carolina.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
320 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 239,840 | $50 | $12M |
| 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. | 22,790 | $270 | $6.2M |
| 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. | 38,270 | $160 | $6.2M |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 1,770 | $2,680 | $4.7M |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 310 | $6,740 | $2.1M |
| 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… | 18,310 | $80 | $1.4M |
| J3490 | Unclassified drugs | 143,890 | $10 | $1.2M |
| 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. | 3,510 | $310 | $1.1M |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 12,390 | $80 | $1M |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 560 | $1,740 | $967.4K |
Showing 1–10 of 320
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
320 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 1 | 10 | 110 | $5,750 | $3.2M |
| 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. | 87 | 330 | 6,130 | $130 | $2.7M |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 11 | 10 | 600 | $1,450 | $2.3M |
| 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… | 14 | 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. | 41 | 320 | 6,160 | $120 | $2.1M |
| 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. | 134 | 280 | 2,690 | $130 | $1.6M |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 14 | 40 | 220 | $60 | $920.5K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 63 | 70 | 280 | $20 | $896.7K |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 16 | 40 | 420 | $1,080 | $841K |
| 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. | 129 | 360 | 1,830 | $40 | $819.8K |
Showing 1–10 of 320
Other providers in the same ZIP code as University Of North Carolina Hospitals At Chapel Hill, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Standards-based Solutions Behavioral Health Consulting | NC | Mental Health Counselor | $0 | $8.3M |
| James Bates | NC | Radiation Oncology Physician | $656.1K | $0 |
| William Delgado | NC | MOHS-Micrographic Surgery Physician | $515.5K | $0 |
| Bradley Merritt | NC | MOHS-Micrographic Surgery Physician | $354.7K | $0 |
| Stephen Goldner | NC | Internal Medicine Physician | $254.7K | $0 |
| Jonathan Pack | NC | Diagnostic Radiology Physician | $235.2K | $0 |
| John Wood | NC | Ophthalmology Physician | $231.7K | $0 |
| North Carolina Cvs Pharmacy LLC | NC | Pharmacy | $217.7K | $0 |
| Timothy Zagar | NC | Radiation Oncology Physician | $207.8K | $0 |
| Joshua Wallace | NC | Diagnostic Radiology Physician | $206.4K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.