Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Georgia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Georgia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Georgia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Otogenetics Corporation (NPI 1063892396)

Key Findings

Field	Value
Entity Type	Organization
Organization	Otogenetics Corporation
Address	4553 Winters Chapel Rd Ste 100
City	Atlanta
State	GA
ZIP	30360
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	June 2, 2015

Payer Source	Total Paid
Medicaid	$21.3M
Medicare	$0

This provider reports no Medicare billing on file and $21.3M in lifetime Medicaid revenue, making its footprint effectively single-payer (Medicaid) in scale. The absence of Medicare claims indicates any payer-concentration risk or contracting leverage will be driven by Medicaid relationships rather than Medicare volumes.

Revenue is highly concentrated in a few tests: the precomputed top‑3 Medicaid codes account for 58.9% of total Medicaid revenue, led by 81420 ($4.5M, 21.4%), 81220 ($4.3M, 20.2%), and 81408 ($3.7M, 17.3%). This concentration implies that shifts in coverage or pricing for those specific codes would materially affect overall revenue.

The code mix indicates a clinical molecular laboratory focused on genetic and reproductive testing: 81420 and 81507 are noninvasive prenatal/fetal aneuploidy panels, 81220 and 81223 target CFTR/cystic fibrosis analyses, and multiple Tier‑level molecular pathology codes (81408, 81404, 81405) and hereditary disease tests (81329, 81161, 81336) point to a core competency in sequencing and targeted genetic diagnostics. This profile is consistent with a lab that packages higher‑complexity panels alongside broad carrier and single‑gene testing.

Competitive standing in Georgia is strong for many of the lab’s high‑revenue tests: the provider ranks #1 and at the 100th percentile in-state for codes including 81420 ( #1 of 3 ), 81220 ( #1 of 2 ), 81408 ( #1 of 10 ), 81405 ( #1 of 9 ) and several single‑gene assays. Those rank/percentile placements indicate the provider is a leading statewide supplier for multiple commonly billed genetic tests, not a marginal participant.

Several codes are flagged as notably above typical state volume or have no state peers for comparison: 81408, 81405 and 81404 are described as notably above typical state volume, while 81443 and 81507 are the only in-state reporters (0th percentile with no peer comparison available). These labels suggest the lab either draws referrals for higher‑complexity panels beyond typical volumes or occupies unique testing niches with limited in-state competition.

Payer price mix shows a combination of high‑value but lower‑frequency panels and low‑value high‑volume assays: examples include high avg paid/claim items such as 81443 ($1968 avg paid/claim) and 81408 ($801 avg paid/claim) alongside high‑volume, lower‑paid tests like 81220 (15.2K claims, $283 avg) and 81329 (7K claims, $85 avg). This mix creates revenue sensitivity both to utilization of premium panels and to unit volume on many routine genetic assays.

Volume patterns reinforce breadth of operations: several codes show very large claim counts (81220 15.2K claims; 81420 11.2K claims; 81257 7.7K claims; 81329 7K claims), indicating established sample throughput and referral relationships across multiple test types. High claim counts on both panel and single‑gene codes support an operational model that handles both mass screening/carrier testing and specialized panel work.

The NPI was enumerated on 2015-06-02 (~11 years ago), indicating roughly a decade of billing history under this identifier. That tenure, combined with leading in-state ranks for many codes and $21.3M Medicaid lifetime revenue, suggests operational stability and an established position for contract discussions focused on Medicaid programs.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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,…	11,230	$410	$4.5M
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…	15,200	$280	$4.3M
81408	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code.	4,610	$800	$3.7M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	1,050	$1,970	$2.1M
81507	The lab analyst performs the technical lab tests to detect fetal trisomies 13, 18 and 21 in the maternal plasma during pregnancy. The analyst uses a micro assay technique and carries out an…	3,210	$530	$1.7M
81223	The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR.	1,660	$640	$1.1M
81405	The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 6 molecular pathology code.	4,540	$160	$722.2K
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	7,010	$90	$596.1K
81404	The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 5 molecular pathology code.	4,580	$120	$549.1K
81259	The lab analyst performs the technical lab test to analyze the entire gene sequence for alpha globin 1 and alpha globin 2 (HBA1/HBA) genes, which relate to alpha thalassemia and some structural…	1,070	$430	$462.9K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Georgia Distribution

Otogenetics Corporation — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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	10	11,550	$310	$3.5M
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	7,630	$440	$2.8M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	1	10	1,050	$1,970	$2.1M
81507	The lab analyst performs the technical lab tests to detect fetal trisomies 13, 18 and 21 in the maternal plasma during pregnancy. The analyst uses a micro assay technique and carries out an…	1	10	3,210	$530	$1.7M
81408	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code.	1	10	480	$520	$503.7K
81161	The lab analyst performs the technical lab test to analyze specific changes involving deleted, or possibly repeated, nucleotide sequences in the dystrophin gene, also known as the DMD gene.	1	10	6,710	$60	$399.6K
81223	The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR.	1	10	350	$540	$320K
81336	The lab analyst performs the technical lab test to analyze the entire gene sequence for the survival of motor neuron 1 (SMN1), telomeric.	1	10	4,440	$70	$310.9K
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	1	10	2,380	$70	$244.8K
81259	The lab analyst performs the technical lab test to analyze the entire gene sequence for alpha globin 1 and alpha globin 2 (HBA1/HBA) genes, which relate to alpha thalassemia and some structural…	2	10	1,180	$200	$237.2K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Quest Diagnostics Incorporated	NJ	Clinical Medical Laboratory	$111.2M	$637.7M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$60.5M	$289.1M
Laboratory Corporation Of America	AZ	Clinical Medical Laboratory	$38.5M	$265.9M

Otogenetics Corporation — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bioconfirm Laboratories LLC	GA	Clinical Medical Laboratory	$0	$6.3M
Alyssa Morrow	GA	Speech-Language Pathologist	$73.8K	$0