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NPI 1013431741 · Denver, CO · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Denver, Colorado. This profile covers 325 Medicare and 104 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 | Quest Diagnostics Clinical Laboratories Inc |
| Address | 695 S Broadway |
| City | Denver |
| State | CO |
| ZIP | 80209 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 3, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $14.3M |
| Medicare | $2.5M |
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC is operating as a high-volume clinical medical laboratory: its Medicare top codes are dominated by routine chemistry and specimen collection (80053, 36415) and endocrine testing (84443), while its Medicaid mix shows heavy investment in infectious disease and microbiology workflows (U0003, 87086, 87088). The presence of large claim counts across panels, cultures, and specific infectious-agent codes indicates a full-service lab performing both high-throughput screening/panel work and detailed microbiology testing.
Revenue concentration differs by payer: the provider's top three Medicare codes (80053, 36415, 84443) account for 27.4% of its total Medicare revenue, signaling a moderate concentration within routine lab services on the Medicare side. On Medicaid the top three codes (U0003, 80050, 87086) account for 46.2% of Medicaid revenue, showing a much higher revenue concentration driven heavily by a few high-volume services.
Payer mix is skewed toward Medicaid: total Medicaid revenue is $14.3M versus total Medicare revenue of $2.5M, so Medicaid represents the larger share of billed revenue for this provider. This scale difference suggests the organization’s operational emphasis and revenue risk are more dependent on state Medicaid volumes and reimbursement patterns.
The provider is a dominant in-state performer for several Medicaid codes: U0003 is $3.5M and ranks #3 of 79 in-state (97th percentile; extreme outlier, far above typical state volume), 87088 is $897.1K and ranks #1 of 24 (100th percentile; extreme outlier), and 87086 is $1.2M and ranks #2 of 64 (98th percentile; extreme outlier). Multiple top Medicaid codes rank at or near #1–#3 statewide, indicating this lab is a major in-state hub for urine culture, other bacterial cultures, and SARS‑CoV‑2 NAAT testing.
Nationally on Medicare the provider shows notable volume in common lab services: 36415 (18K claims, $144.3K revenue) ranks #137 of 86467 providers (100th percentile; notably above typical national volume), 80053 (17.2K claims, $171.6K revenue) ranks #144 of 26416 (99th percentile), and 84443 (8.3K claims, $133.2K revenue) ranks #155 of 19722 (99th percentile). These national high percentiles for routine panels and venipuncture indicate the lab participates at scale on Medicare for core diagnostic services, even though overall Medicare revenue is modest relative to Medicaid.
Microbiology and susceptibility testing are a clear service-line strength on Medicaid: 87086 (147.9K claims, $1.2M), 87088 (112.1K claims, $897.1K), 87186 (41.6K claims, $333K), and 87077 (39.9K claims, $319.1K) all appear as high-volume entries and are labeled as extreme outlier or notably above typical state volume. This pattern reflects substantial investment in culture workstreams and antimicrobial susceptibility capacity, which supports broad clinical microbiology throughput and specialty reporting.
SARS‑CoV‑2 testing is a material driver of Medicaid revenue: U0003 accounts for $3.5M (27.2% of Medicaid revenue) with 47.6K claims and is described as an extreme outlier in-state, while U0005 contributes $652.4K (5.1% of Medicaid revenue) with 28.4K claims. Together these codes constitute a concentrated, high-throughput COVID testing operation within the Medicaid payer mix and are major contributors to the provider’s in-state revenue profile.
The practice has an established enrollment history with NPI enumeration on 2017-08-03 (~9 years ago), supporting nearly a decade of billing data; combined with the high-volume Medicaid footprint and national Medicare presence on routine codes, this tenure aligns with a sustained operational platform capable of handling both high-throughput state contracts (e.g., SARS‑CoV‑2 testing) and ongoing Medicare diagnostic volume.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
325 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 17,160 | $10 | $171.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 18,040 | $10 | $144.3K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 8,320 | $20 | $133.2K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 10,020 | $10 | $130.2K |
| 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… | 14,570 | $10 | $116.5K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 13,060 | $10 | $104.4K |
| 87088 | The lab analyst or microbiologist observes a urine culture with an unknown organism or organisms and makes a presumptive identification of each organism that needs identification. | 11,350 | $10 | $90.8K |
| 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… | 710 | $110 | $79K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 7,250 | $10 | $72.5K |
| 84403 | The lab analyst performs a test to measure total testosterone, typically in patient serum. | 2,710 | $30 | $67.8K |
Showing 1–10 of 325
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 325 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
104 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 47,580 | $70 | $3.5M |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 30,890 | $40 | $1.2M |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 147,920 | $10 | $1.2M |
| 87088 | The lab analyst or microbiologist observes a urine culture with an unknown organism or organisms and makes a presumptive identification of each organism that needs identification. | 112,140 | $10 | $897.1K |
| 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. | 79,020 | $10 | $790.2K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 55,780 | $10 | $725.1K |
| 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,… | 28,370 | $20 | $652.4K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 51,890 | $10 | $467K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 28,790 | $20 | $460.6K |
| 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… | 48,990 | $10 | $342.9K |
Showing 1–10 of 104
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
104 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 2 | 30 | 230 | $40 | $428.1K |
| 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… | 3 | 80 | 830 | $70 | $274.8K |
| 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. | 3 | 180 | 1,040 | $10 | $127.6K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 9 | 90 | 90 | $30 | $94.3K |
| 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,… | 3 | 50 | 750 | $20 | $91.8K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 17 | 110 | 380 | $10 | $80.9K |
| 87088 | The lab analyst or microbiologist observes a urine culture with an unknown organism or organisms and makes a presumptive identification of each organism that needs identification. | 1 | 20 | 340 | $10 | $78.2K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 4 | 130 | 290 | $10 | $67.3K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 2 | 60 | 360 | $10 | $62.6K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 4 | 130 | 390 | $10 | $60.3K |
Showing 1–10 of 104
Other providers in the same ZIP code as Quest Diagnostics Clinical Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Colorado Pathology Consultants PC | CO | Clinical Medical Laboratory | $607.1K | $13.2M |
| Mark Malyak | CO | Rheumatology Physician | $1.2M | $0 |
| Nathaniel Moore | CO | Family Medicine Physician | $640K | $0 |
| Global Reach Labs, LLC | CO | Clinical Medical Laboratory | $526.1K | $410 |
| Kelly Mcaleese | CO | Specialist | $515.1K | $0 |
| William Schuh | CO | Specialist | $489.6K | $0 |
| Drew Taylor | CO | Dermatology Physician | $475.9K | $0 |
| Hunter Sams | CO | Dermatology Physician | $135.6K | $0 |
| Derick Levy | CO | Physical Therapist | $114.1K | $0 |
| Timothy Colt | CO | Specialist | $89.2K | $0 |
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