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NPI 1033281324 · Clermont, FL · Clinical Medical Laboratory
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Advanced Clinical Laboratories, Inc. is a clinical medical laboratory provider located in Clermont, Florida. This profile covers 172 Medicare and 141 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 | Advanced Clinical Laboratories, Inc. |
| Address | 3705 S Hwy 27 Ste 101 |
| City | Clermont |
| State | FL |
| ZIP | 34711 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $5.7M |
| Medicaid | $1.8M |
ADVANCED CLINICAL LABORATORIES, INC. operates as a high-volume clinical medical laboratory with a mixed service model: the Medicare mix is dominated by travel/specimen-collection allowances and facility-based draws (P9603, G0471) while core lab analytics (85025, 80053, 80048) and molecular testing (U0003, 87798) also appear throughout the top codes. The presence of both P9603 (1.4M claims, $1 avg paid/claim, $1.4M revenue) and large counts for routine panels such as 85025 (47.7K claims, $8 avg paid/claim, $382K revenue) signals an operation that combines mobile/specimen-collection logistics with centralized analytic capacity.
Revenue concentration is pronounced on Medicare: the top three Medicare codes account for 53.3% of this provider’s total Medicare revenue, driven by P9603 (29.6%), G0471 (15.8%), and 85025 (7.9%). This concentration indicates that a small set of services — notably travel/specimen-collection allowances and high-volume CBC testing — are responsible for the majority of Medicare dollars reported.
Medicaid billing is even more concentrated toward a few codes: the top three Medicaid codes account for 62.2% of the provider’s total Medicaid revenue, led by U0003 at $705.1K (44.1%), followed by 80053 at $178.9K (11.2%) and 80048 at $112.3K (7.0%). The Medicaid profile highlights very large state-level volume in SARS‑CoV‑2 PCR testing (U0003) plus routine metabolic panels, making COVID molecular testing the single largest Medicaid revenue driver.
The payer mix favors Medicare in scale: total Medicare revenue is $5.7M compared with total Medicaid revenue of $1.8M, so Medicare is the primary revenue source on file. Both payers are active, but the provider’s Medicaid activity is heavily weighted toward COVID PCR and routine panels whereas Medicare shows heavier use of travel allowances and a broader set of routine and molecular tests.
Competitive standing on national Medicare coding shows multiple extreme outlier signals: P9603 ranks #7 of 267 providers nationally (98th percentile; extreme outlier) and 85025 ranks #63 of 32833 providers nationally (100th percentile; extreme outlier), while 80048 ranks #52 of 14725 (100th percentile; extreme outlier) and 80053 ranks #90 of 26416 (100th percentile; notably above typical national volume). These rank results indicate the provider is a major national volume participant for several routine and collection-related laboratory codes, consistent with unusually high throughput or broad collection operations.
Within Florida Medicaid, the provider is a state-level outlier for COVID PCR volume: U0003 ranks #4 of 320 providers in-state (99th percentile; extreme outlier) and the provider also ranks #1 of 29 for 88112 (100th percentile; extreme outlier) for a cytology-related code. Those in-state rankings suggest this lab is a dominant source of certain high-volume services in Florida, particularly high-throughput SARS‑CoV‑2 testing and selected cytology workflows.
The scale-and-price profile shows dependence on high-claim, low-unit-pay items alongside higher-margin molecular claims: for example, P9603 is 1.4M claims at $1 avg paid/claim producing $1.4M revenue, while U0003 appears at much higher per-claim payment in Medicare ($74 avg paid/claim) but dominates Medicaid revenue through volume ($705.1K, 88.1K claims at $8 avg paid/claim). Operationally, that mix points to a business model that relies on very large specimen-collection throughput and centralized molecular testing capacity to generate revenue.
The provider has a long operational history on file, with NPI enumeration dated 2006-11-14 (~20 years ago), which supports an interpretation of an established lab network and sustained payer relationships. Longevity combined with the observed national and state rank outlier positions makes this entity a well-established, high-volume laboratory service provider rather than a recent entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
172 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 1,425,750 | $1 | $1.4M |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 76,080 | $10 | $760.8K |
| 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… | 47,750 | $10 | $382K |
| 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. | 32,830 | $10 | $328.3K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 8,360 | $30 | $284.4K |
| 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… | 11,100 | $20 | $177.6K |
| 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… | 18,620 | $10 | $148.9K |
| 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. | 9,820 | $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… | 3,970 | $30 | $115.2K |
| 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).… | 10,970 | $10 | $109.7K |
Showing 1–10 of 172
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 172 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
172 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G0471 | 3 | 10 | 41,970 | $10 | $631.6K |
| P9603 | 2 | 40 | 43,600 | $1 | $290.1K |
| 87798 | 12 | 110 | 590 | $30 | $218.6K |
| 83698 | 6 | 10 | 240 | $50 | $104.5K |
| 87536 | 7 | 10 | 90 | $80 | $100.3K |
| 82652 | 5 | 10 | 470 | $40 | $93.8K |
| 86480 | 10 | 20 | 90 | $60 | $87.3K |
| 88305 | 903 | 980 | 570 | $40 | $83.5K |
| 87481 | 20 | 80 | 340 | $30 | $72.8K |
| 86003 | 9 | 10 | 590 | $10 | $68.3K |
Showing 1–10 of 172
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.
141 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… | 88,140 | $10 | $705.1K |
| 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. | 178,860 | $1 | $178.9K |
| 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… | 112,260 | $1 | $112.3K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 10,650 | $10 | $74.5K |
| 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… | 56,720 | $1 | $56.7K |
| 87186 | The lab analyst performs the technical steps to evaluate a culture isolate’s susceptibility, or sensitivity, to multiple antimicrobial agents, commonly called antibiotics, by observing growth of the… | 48,280 | $1 | $48.3K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 23,840 | $1 | $47.7K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 9,350 | $10 | $46.8K |
| 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. | 44,730 | $1 | $44.7K |
| 82652 | The lab analyst measures the level of vitamin D, 1, 25 dihydroxy, a fat soluble steroid that stimulates calcium absorption in the intestine. Vitamin D, 1, 25 dihydroxy is the hormonally active form… | 12,670 | $1 | $38K |
Showing 1–10 of 141
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
141 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… | 4 | 320 | 750 | $40 | $232.7K |
| 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. | 16 | 640 | 4,400 | $10 | $193.4K |
| 84520 | The lab analyst performs a test to measure the amount of urea nitrogen in patient blood. | 219 | 300 | 1,170 | $60 | $186K |
| 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… | 39 | 70 | 180 | $20 | $178K |
| 82310 | The lab analyst measures the calcium level, primarily on a serum sample. | 205 | 220 | 880 | $50 | $151.3K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 36 | 160 | 450 | $50 | $115.7K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 31 | 440 | 610 | $40 | $111.5K |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 17 | 460 | 510 | $50 | $110.2K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 82 | 100 | 370 | $10 | $106K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 305 | 340 | 720 | $10 | $100.6K |
Showing 1–10 of 141
Other providers in the same ZIP code as Advanced Clinical Laboratories, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| South Lake Hospital, Inc. | FL | General Acute Care Hospital | $0 | $16.9M |
| Pediatric Services Of America, LLC | FL | Nursing Care Agency | $0 | $15.5M |
| Compassionate Care Advocates | FL | In Home Supportive Care Agency | $0 | $7.2M |
| Ahmed Al-hazzouri | FL | Medical Oncology Physician | $3.5M | $0 |
| Shubha Kollampare | FL | Rheumatology Physician | $2.1M | $0 |
| Physicians Stat Lab Inc. | FL | Clinical Medical Laboratory | $1.9M | $99.1K |
| Raam Sambandam | FL | Clinical Neurophysiology Physician | $1.3M | $0 |
| Priya Prakash | FL | Rheumatology Physician | $1.2M | $0 |
| Clermont Radiology LLC | FL | Radiology Clinic/Center | $972.9K | $6.3K |
| Gopal Kunta | FL | Hematology & Oncology Physician | $744.6K | $80 |
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