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NPI 1023786233 · Irvine, CA · Clinical Medical Laboratory
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Shoreline Diagnostics LLC is a clinical medical laboratory provider located in Irvine, California. This profile covers 5 Medicare and 8 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 | Shoreline Diagnostics LLC |
| Address | 1 Technology Dr Ste D407 |
| City | Irvine |
| State | CA |
| ZIP | 92618 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 1, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $9.6M |
| Medicare | $6.2M |
SHORELINE DIAGNOSTICS LLC operates as a high-volume clinical medical laboratory focused on SARS‑CoV‑2 testing and specimen collection: Medicare billing shows U0003 with 47.1K claims and $3.5M revenue and U0005 with 47K claims and $1.2M revenue, while Medicaid billing shows U0003 with 108.3K claims and $6.3M revenue and G2023 with 91.3K claims and $1.6M revenue. The top CPT/HCPCS in both payers are specific to nucleic acid detection and specimen collection, indicating core operational capacity in high-throughput COVID‑19 molecular testing rather than a broad diagnostic menu.
Revenue is highly concentrated in a few COVID‑related codes: the top 3 Medicare codes account for 88.0% of this provider's total Medicare revenue and the top 3 Medicaid codes account for 95.0% of this provider's total Medicaid revenue. This concentration implies a narrow revenue base tied to a small set of testing services.
The provider’s payer mix is skewed toward Medicaid in scale: total Medicaid revenue is $9.6M compared with total Medicare revenue of $6.2M, so Medicaid constitutes the larger single payer relationship rather than the entity being effectively single‑payer. Both payers are material to overall volume given multi‑million dollar totals on each side.
On Medicare measures the provider is a national outlier for core COVID testing codes: U0003 ranks #5 of 973 providers nationally (100th percentile; extreme outlier), U0005 ranks #5 of 1090 providers nationally (100th percentile; extreme outlier), and G2023 ranks #6 of 465 providers nationally (99th percentile; extreme outlier). These ranks and percentiles indicate SHORELINE is a dominant national volume performer for those specific Medicare codes.
In-state competitive standing on Medicaid is also strong but uneven: U0003 ranks #24 of 751 in-state (97th percentile; typical, unremarkable volume) while G2023 ranks #10 of 497 in-state (98th percentile; notably above typical state volume) and 87635 ranks #12 of 1207 in-state (99th percentile; extreme outlier). This mix shows the provider is a significant California player for specimen collection and nucleic acid testing, with particular dominance on certain molecular assays.
Payer reimbursement per claim shows measurable differences across payers and codes that affect revenue mix: for example U0003 is $74 avg paid/claim on Medicare versus $58 avg paid/claim on Medicaid, U0005 is $25 avg paid/claim on Medicare versus $9 avg paid/claim on Medicaid, and G2023 is $23 avg paid/claim on Medicare versus $17 avg paid/claim on Medicaid. Those per‑claim differences, combined with the large claim counts reported, materially shape the provider’s revenue profile across payers.
The NPI was enumerated 2021-09-01 (~5 years ago), indicating relatively recent market entry but rapid scale-up given the $6.2M in Medicare revenue and $9.6M in Medicaid revenue reported over its lifetime. Rapid growth in a short operational window is consistent with a laboratory that expanded capacity to serve pandemic testing demand.
High dependence on COVID‑specific codes (U0003, U0005, G2023, 87635) creates concentration risk as testing demand or coding/reimbursement policies evolve; the provider’s top three Medicaid codes already represent 95.0% of Medicaid revenue and the top three Medicare codes represent 88.0% of Medicare revenue. Absent visible diversification into non‑COVID diagnostics in the reported top codes, the revenue base is vulnerable to reductions in pandemic testing volumes or changes in payer coverage policies.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 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… | 47,070 | $70 | $3.5M |
| 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,… | 47,050 | $30 | $1.2M |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 34,890 | $20 | $802.4K |
| 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… | 14,930 | $50 | $746.5K |
| 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,… | 50 | $40 | $1.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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.
8 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… | 108,280 | $60 | $6.3M |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 91,290 | $20 | $1.6M |
| 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… | 34,030 | $40 | $1.3M |
| 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,… | 43,170 | $10 | $388.5K |
| 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,… | 3,150 | $30 | $81.8K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 180 | $70 | $11.8K |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 60 | $30 | $1.4K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 20 | $1 | $50 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
8 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… | 24 | 750 | 950 | $50 | $890K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 182 | 250 | 800 | $110 | $625.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 10 | 500 | 530 | $20 | $128.1K |
| 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,… | 18 | 520 | 470 | $10 | $116K |
| 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… | 12 | 1,210 | 420 | $30 | $95.7K |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 46 | 60 | 720 | $20 | $89.1K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 252 | 270 | 470 | $40 | $40.8K |
| 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,… | 135 | 820 | 290 | $20 | $40.7K |
Other providers in the same ZIP code as Shoreline Diagnostics LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Mdxhealth, Inc. | CA | Clinical Medical Laboratory | $24M | $797.5K |
| Biognomics Lab, LLC | CA | Clinical Laboratory Director (Non-physician) | $16.4M | $235.6K |
| Agendia Inc | CA | Clinical Medical Laboratory | $10.2M | $5.1M |
| Cap Diagnostics LLC | CA | Clinical Medical Laboratory | $3.4M | $10.8M |
| Healthquest Esoterics Inc | CA | Clinical Medical Laboratory | $159K | $6.7M |
| Specialty Surgical Center Of Irvine LP | CA | Ambulatory Surgical Clinic/Center | $1.1M | $1.4M |
| Fang Yu | CA | Gastroenterology Physician | $121.8K | $2.1M |
| Emeritus Medical Technology LLC | CA | Clinical Medical Laboratory | $1.9M | $20.8K |
| Sandeep Thakkar | CA | Neurology Physician | $1.4M | $92.5K |
| Kenneth Tokita | CA | Radiation Oncology Physician | $1.3M | $0 |
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