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NPI 1073272613 · Manteca, CA · Clinical Medical Laboratory
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West Coast Medical Labs Inc is a clinical medical laboratory provider located in Manteca, 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 | West Coast Medical Labs Inc |
| Address | 520 E Center St Ste 103 |
| City | Manteca |
| State | CA |
| ZIP | 95336 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | December 10, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $12.2M |
| Medicaid | $3.4M |
WEST COAST MEDICAL LABS INC is classified as a Clinical Medical Laboratory and its billing mix is heavily centered on SARS‑CoV‑2 testing and high‑throughput respiratory diagnostics. Medicare top codes U0003 ($4.8M revenue, 38.8% of this provider's total Medicare revenue), G2023 ($3.1M revenue, 25.5%), and 87811 ($2.7M revenue, 21.5%) together dominate the lab’s Medicare activity and reflect a workflow built around molecular and immunoassay COVID testing. The presence of multiplex and high‑throughput code activity implies central lab operations rather than small point‑of‑care testing.
Medicare revenue for this provider is highly concentrated: the precomputed top three Medicare codes account for 85.8% of total Medicare revenue. That concentration is driven by U0003, G2023, and 87811, indicating that a small set of pandemic‑era test codes make up most of Medicare billings. This level of concentration suggests business dependence on respiratory pathogen testing lines.
On the Medicaid side the revenue concentration is even more extreme: the precomputed top three Medicaid codes account for 97.4% of total Medicaid revenue. The Medicaid mix is led by 87636 ($2.0M revenue, 58.8% of this provider's total Medicaid revenue) and 0202U ($1.1M revenue, 33.8%), with 87635 ($160.8K, 4.8%) completing the top three, indicating Medicaid payments are likewise focused on multiplex respiratory panels and a PLA respiratory panel product. This creates a Medicaid footprint tightly tied to respiratory panel offerings rather than a broad menu of lab services.
WEST COAST MEDICAL LABS demonstrates a nationally outsized Medicare presence for COVID testing codes: U0003 ranks #2 of 973 providers nationally (100th percentile; extreme outlier), G2023 ranks #1 of 465 providers nationally (100th percentile; extreme outlier), and 87811 ranks #2 of 10132 providers nationally (100th percentile; extreme outlier). These rankings and the “extreme outlier” labels indicate the provider is a dominant, high‑volume national performer for these specific COVID testing codes rather than a typical regional lab. Such dominance on Medicare suggests scale and throughput capabilities that exceed nearly all peers for these services.
In contrast, the provider’s standing on Medicaid is more mixed but still strong for multiplex respiratory testing: 87636 ranks #16 of 276 providers in‑state (95th percentile; notably above typical state volume), while 0202U and 87635 appear at typical to unremarkable state volumes. This pattern positions the lab as a leading in‑state provider for multiplex SARS‑CoV‑2/influenza testing but a more modest competitor on other Medicaid codes, indicating differentiated competitiveness by test type.
Payer mix is skewed toward Medicare in absolute scale: lifetime Medicare revenue is $12.2M versus lifetime Medicaid revenue of $3.4M. The provider is therefore not single‑payer; Medicare represents the larger revenue pool and likely a primary operational focus for billing and collections. Analysts should treat Medicare performance as the more material driver of overall revenue trends for this entity.
The provider’s NPI was enumerated 2021-12-10 (~5 years ago), which places its formal enrollment near the height of COVID testing demand. That timing aligns with the code mix concentrated in pandemic‑era molecular and multiplex respiratory testing, suggesting the lab was either launched or scaled up in response to COVID testing needs. Tenure of ~5 years combined with extreme national volumes on key codes implies rapid buildout of testing capacity in a short timeframe.
Because revenue and volumes are heavily concentrated in pandemic‑related and multiplex respiratory codes, the provider’s financial performance may be sensitive to shifts in public health testing demand, reimbursement policy, or guideline changes for SARS‑CoV‑2 testing. The top‑code concentration (85.8% Medicare, 97.4% Medicaid) means changes affecting a small set of codes — for example testing frequency, coverage, or payment rates — could materially affect overall revenue.
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… | 64,730 | $70 | $4.8M |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 136,700 | $20 | $3.1M |
| 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… | 64,660 | $40 | $2.7M |
| 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,… | 64,620 | $30 | $1.6M |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 1,020 | $140 | $142.1K |
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 |
|---|---|---|---|---|
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 19,230 | $100 | $2M |
| 0202U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the… | 4,100 | $280 | $1.1M |
| 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… | 3,740 | $40 | $160.8K |
| 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)… | 500 | $140 | $70.9K |
| 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… | 1,110 | $10 | $8.9K |
| 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… | 1,240 | $1 | $3.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,230 | $1 | $2.2K |
| 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,… | 800 | $1 | $800 |
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… | 340 | 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)… | 148 | 250 | 800 | $110 | $625.7K |
| 0202U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the… | 18 | 90 | 740 | $210 | $382.4K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 16 | 280 | 730 | $90 | $315.5K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 151 | 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,… | 225 | 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… | 219 | 1,210 | 420 | $30 | $95.7K |
| 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… | 173 | 620 | 320 | $20 | $50.3K |
Other providers in the same ZIP code as West Coast Medical Labs Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Valley Cancer Medical Center Inc | CA | Specialist | $0 | $43.8M |
| Doctors Hospital Of Manteca, Inc. | CA | General Acute Care Hospital | $0 | $23.5M |
| Siraj Ahmed | CA | Pulmonary Disease Physician | $420.9K | $0 |
| Foad Elahi | CA | Pain Medicine (Physical Medicine & Rehabilitation) Physician | $224.7K | $0 |
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