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NPI 1063497451 · Raritan, NJ · Clinical Medical Laboratory
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Laboratory Corporation Of America Holdings is a clinical medical laboratory provider located in Raritan, New Jersey. This profile covers 645 Medicare and 712 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 | Laboratory Corporation Of America Holdings |
| Address | 69 1st Ave |
| City | Raritan |
| State | NJ |
| ZIP | 08869 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | December 8, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $717.5M |
| Medicare | $143.3M |
This entity reports Medicare revenue of $143.3M and Medicaid revenue of $717.5M, making its Medicaid billing base materially larger than its Medicare business; the scale of Medicaid receipts suggests the organization operates at a size and throughput typical of a statewide or regional reference laboratory rather than a small point-of-care lab. The disparity in scale implies payer mix exposure concentrated on Medicaid-covered testing volumes.
Revenue concentration is meaningful on both payers: the top 3 Medicare codes by revenue account for 35.5% of this provider's total Medicare revenue, and the top 3 Medicaid codes by revenue account for 35.0% of its total Medicaid revenue. For Medicare the highest-revenue codes are led by 80053, 36415, and 80061, while Medicaid top-revenue codes are led by U0003, 80307, and 87491, indicating a concentrated set of services drive roughly one-third of revenue on each payer.
The code mix signals a large, centralized clinical laboratory operation: Medicare volumes are dominated by panels and routine diagnostics (80053 CMP, 80061 lipid panel) plus specimen collection (36415), while Medicaid volumes emphasize high-throughput molecular and screening work (U0003 COVID PCR, 87491 chlamydia NAAT, 87591 gonorrhea NAAT) and very large drug-screening volumes (80307). Together these patterns are consistent with a reference-lab business model that processes mass outpatient specimens and high-volume public-health testing.
Competitive standing on Medicare is national and extreme for many common lab codes: numerous top Medicare codes (for example 80053, 36415, 80061, 84443) are listed as 100th percentile and described as "extreme outlier," with rank positions at #1 or #2 nationally. This profile characterizes the provider as a dominant national-volume participant for many routine clinical lab services rather than a modest local provider.
Competitive standing within New Jersey Medicaid is similarly dominant: multiple high-revenue Medicaid codes (including 80307, 87491, 87591, 80050, and 82306) rank #1 in-state and are labeled as "extreme outlier" compared with in-state peers, and U0003 is a very large single Medicaid revenue contributor ($98.6M, 19.5% of Medicaid revenue) that ranks #2 in-state. These rankings indicate this provider is a major state-level supplier for molecular, screening, and toxicology testing to Medicaid populations.
Service breadth includes both very high-volume routine assays and higher-complexity molecular/genomic testing: Medicaid revenue includes specialized codes such as 81420 (NIPT, $15.3M) and 81220 (CFTR testing, $14.5M), while Medicare lists genomic and algorithmic tests such as 81490 contributing material revenue. The coexistence of routine panels and specialized, higher-paid assays points to capabilities across high-throughput chemistry/hematology and higher-complexity molecular/genetics services.
The dataset flags the provider as a statistical outlier across many codes: numerous entries are described as "extreme outlier" or "notably above typical" at either national (Medicare) or in-state (Medicaid) comparisons. That consistent outlier status across a broad set of CPT/HCPCS codes supports an interpretation of centralized, high-throughput lab operations handling unusually large specimen volumes, rather than isolated spikes in single-code billing.
The provider has an established tenure in the NPI system, enumerated on 2005-12-08 (~21 years ago), which—combined with the large Medicare and Medicaid volumes—supports that this is a mature, long-standing laboratory operation with both routine and specialized testing lines rather than a recent entrant to the market.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
645 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. | 1,160,570 | $10 | $11.6M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1,362,540 | $10 | $10.9M |
| 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. | 828,880 | $10 | $10.8M |
| 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… | 650,140 | $20 | $10.4M |
| 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… | 288,560 | $30 | $8.4M |
| 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… | 843,640 | $10 | $6.7M |
| 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).… | 605,350 | $10 | $6.1M |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 162,010 | $20 | $2.9M |
| 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. | 68,350 | $40 | $2.7M |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 274,670 | $10 | $2.5M |
Showing 1–10 of 645
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 645 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
645 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81490 | 1 | 10 | 1,840 | $820 | $1.5M |
| 81450 | 5 | 10 | 230 | $740 | $833.5K |
| 87506 | 8 | 10 | 110 | $260 | $506.1K |
| 81223 | 6 | 10 | 830 | $490 | $467.8K |
| G0145 | 1 | 10 | 11,530 | $30 | $288.2K |
| 87798 | 5 | 40 | 1,760 | $30 | $284.3K |
| 81162 | 8 | 10 | 80 | $1,790 | $271.4K |
| 88185 | 3 | 20 | 690 | $20 | $265.7K |
| G0472 | 1 | 10 | 5,530 | $50 | $253.9K |
| P9603 | 7 | 10 | 11,620 | $1 | $245.2K |
Showing 1–10 of 645
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.
712 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… | 1,409,070 | $70 | $98.6M |
| 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. | 2,270,060 | $20 | $43.1M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 2,732,720 | $10 | $35.5M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 2,718,270 | $10 | $35.3M |
| 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… | 1,455,820 | $20 | $33.5M |
| 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… | 2,911,720 | $10 | $23.3M |
| 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. | 5,567,720 | $1 | $22.3M |
| 86480 | The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies. | 699,330 | $30 | $18.2M |
| 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. | 5,649,010 | $1 | $16.9M |
| 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… | 839,390 | $20 | $16.8M |
Showing 1–10 of 712
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
712 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… | 2 | 130 | 3,180 | $60 | $4.2M |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 1 | 10 | 5,420 | $280 | $4.1M |
| 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… | 10 | 30 | 2,020 | $110 | $2M |
| 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… | 1 | 40 | 590 | $20 | $1.9M |
| 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. | 1 | 150 | 3,680 | $30 | $1.5M |
| G0481 | 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… | 9 | 40 | 1,690 | $70 | $1.4M |
| 86480 | The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies. | 1 | 40 | 810 | $30 | $1.4M |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 1 | 20 | 750 | $10 | $1.3M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 1 | 30 | 210 | $200 | $1.3M |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 2 | 10 | 51,370 | $40 | $1.3M |
Showing 1–10 of 712
Other providers in the same ZIP code as Laboratory Corporation Of America Holdings, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Alternatives, Inc. | NJ | Community/Behavioral Health Agency | $0 | $105.5M |
| Delta Community Supports, Inc. | NJ | Developmentally Disabled Services Day Training Agency | $0 | $45.3M |
| Delta Community Supports, Inc. | NJ | Intellectual and/or Developmental Disabilities Residential Treatment Facility | $0 | $31.6M |
| Rajendrakumar Patel | NJ | Internal Medicine Physician | $717.2K | $0 |
| Michelle Domingo | NJ | Physician Assistant | $125.1K | $0 |
| Farah Hussain-said | NJ | Audiologist-Hearing Aid Fitter | $8.8K | $0 |
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