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NPI 1023479623 · Burlington, NC · Clinical Medical Laboratory
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Alpha Diagnostics, LLC is a clinical medical laboratory provider located in Burlington, North Carolina. This profile covers 6 Medicare and 11 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 | Alpha Diagnostics, LLC |
| Address | 204 Huffman Mill Rd |
| City | Burlington |
| State | NC |
| ZIP | 27215 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | March 10, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $11M |
| Medicaid | $1M |
ALPHA DIAGNOSTICS, LLC’s Medicare billing is overwhelmingly driven by SARS-CoV-2 testing: U0003 (59.1K claims, $4.4M revenue, 39.6% of Medicare), 86328 (59.1K claims, $2.6M revenue, 23.6% of Medicare), and 87426 (59.2K claims, $2.1M revenue, 18.8% of Medicare) together make up the provider’s core service mix. The code descriptions indicate a laboratory operation centered on high-throughput NAAT PCR testing, antigen testing, and antibody immunoassays for COVID-19 rather than a broad clinical laboratory mix of unrelated diagnostic services.
Revenue concentration on Medicare is acute: the precomputed top-3 Medicare codes by revenue account for 82.0% of this provider’s total Medicare revenue. That concentration signals material dependence on a small set of pandemic-era test codes to generate the majority of the $11M in Medicare revenue on file.
On Medicare the provider is a national volume leader for key COVID-19 codes: U0003 ranks #3 of 973 providers nationally (100th percentile; extreme outlier), 86328 ranks #2 of 119 providers nationally (99th percentile; extreme outlier), and 87426 ranks #1 of 17750 providers nationally (100th percentile; extreme outlier). These ranks characterize ALPHA DIAGNOSTICS as an unusually large national testing participant for these specific codes, far above typical national volume.
Medicaid billing shows a different product mix with definitive drug testing as the single largest Medicaid revenue driver: G0483 accounts for 2.7K claims and $456.6K (45.0% of this provider’s total Medicaid revenue). Combined with U0003 ($274.6K, 27.1%) and U0005 ($93.8K, 9.2%), the precomputed top-3 Medicaid codes account for 81.3% of the provider’s $1M in Medicaid revenue, indicating a concentrated Medicaid service line split between drug testing and SARS-CoV-2 testing.
Competitive standing in-state is mixed: for G0483 the provider ranks #48 of 113 (58th percentile; typical, unremarkable volume), so it is a modest participant in definitive drug testing statewide; by contrast U0003 ranks #23 of 158 (86th percentile; typical, unremarkable volume) and G2023 ranks #11 of 232 (96th percentile; typical, unremarkable volume), showing stronger relative positioning on some SARS-CoV-2 specimen-collection and testing services in-state. Notably, K1034 ranks #1 of 5 in-state (100th percentile; notably above typical state volume), which points to above-typical Medicaid billing for nonprescription self-test provisioning despite the small provider denominator for that code.
Payer mix is skewed heavily toward Medicare: Total Medicare revenue is $11M versus Total Medicaid revenue of $1M, so the provider’s overall billing footprint is Medicare-dominant. Medicaid exists as a secondary revenue stream with concentrated pockets (drug testing and selected COVID codes) rather than broad parity with Medicare.
The provider has been NPI enumerated since 2016-03-10 (~10 years ago), meaning it was an established entity before the COVID-19 pandemic. That tenure, coupled with extremely high national volumes on pandemic-related codes, suggests an established laboratory that either scaled COVID testing capacity or captured significant testing volume during pandemic response.
Operational profile nuance: Medicare shows very large volumes and revenue concentrated in lab test codes (U0003, 86328, 87426) while some ancillary services are marginal—e.g., Medicare G2023 appears as 49 claims and $1.1K revenue (0.0% of Medicare), indicating specimen-collection or ancillary billing is minor relative to test processing. On Medicaid, definitive drug testing (G0483) and several SARS-CoV-2 codes together drive the bulk of revenue, implying separate service lines (drug panels vs. infectious disease testing) that dominate each payer’s book.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 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… | 59,140 | $70 | $4.4M |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 59,140 | $40 | $2.6M |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 59,170 | $40 | $2.1M |
| 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,… | 59,130 | $30 | $1.5M |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 42,520 | $10 | $510.2K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 50 | $20 | $1.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 2,670 | $170 | $456.6K |
| 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… | 8,580 | $30 | $274.6K |
| 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,… | 8,530 | $10 | $93.8K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 9,010 | $10 | $90.1K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 3,560 | $20 | $60.6K |
| 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. | 610 | $60 | $34.7K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 50 | $30 | $1.5K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 90 | $10 | $1.2K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 50 | $20 | $1.2K |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 440 | $1 | $440 |
Showing 1–10 of 11
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
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 23 | 160 | 840 | $70 | $2.3M |
| 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… | 48 | 110 | 1,450 | $110 | $1.7M |
| 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. | 237 | 360 | 1,830 | $40 | $819.8K |
| 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,… | 21 | 130 | 890 | $20 | $259.7K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 371 | 490 | 260 | $40 | $80.3K |
| 87811 | The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by… | 145 | 190 | 300 | $30 | $66.5K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 257 | 320 | 280 | $60 | $63.8K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 44 | 440 | 240 | $30 | $49.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 11 | 230 | 360 | $20 | $34.9K |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 5 | 30 | 100 | $30 | $20.4K |
Showing 1–10 of 11
Other providers in the same ZIP code as Alpha Diagnostics, LLC, ranked by combined Medicare and Medicaid revenue.
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