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 North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Laboratory Corporation Of America (NPI 1104829159)

Key Findings

Field	Value
Entity Type	Organization
Organization	Laboratory Corporation Of America
Address	531 S Spring St
City	Burlington
State	NC
ZIP	27215
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	May 23, 2005

Payer Source	Total Paid
Medicaid	$59.4M
Medicare	$0

LABORATORY CORPORATION OF AMERICA in Burlington, NC reports $59.4M in lifetime Medicaid revenue and has none (no Medicare billing on file), making its billed footprint effectively single‑payer Medicaid in the available data. The absence of Medicare billing on file contrasts with the sizable Medicaid volume and implies state Medicaid policy and contracts are the dominant revenue drivers for this NPI.

Revenue concentration is material: the top three Medicaid codes are U0003 ($5M, 12.3%), 80061 ($3M, 7.2%), and 88305 ($2.9M, 7.2%), and those top 3 codes together account for 26.7% of this provider's total Medicaid revenue. This concentration indicates a meaningful share of Medicaid revenue is tied to a small set of high‑volume or high‑value tests, so shifts in reimbursement or utilization for these codes would disproportionately affect overall Medicaid receipts.

The code mix and claim volumes point to a high‑throughput clinical laboratory operation that processes large volumes of routine chemistry and hematology panels. Examples include 80053 with 1.2M claims ($2 avg paid/claim, $2.4M revenue), 85025 with 1.1M claims ($2 avg paid/claim, $2.3M revenue), and 84443 with 830K claims ($3 avg paid/claim, $2.5M revenue), consistent with centralized processing of low‑unit‑price, high‑volume diagnostic tests.

State competitive standing is dominant for many routine tests: 80061 ranks #2 of 325 providers in‑state (100th percentile; extreme outlier, far above typical state volume), and several other routine panels (80053, 85025, 83036, 84443) also rank at or near #2 with 99–100th percentile designations. These high ranks and percentile placements indicate the lab is a primary in‑state provider for standard clinical panels rather than a modest local participant.

Alongside routine panels, the provider also reports meaningful activity in higher‑reimbursement molecular and genomic services, signaling a mixed service line that includes specialty testing. Notable examples are 81220 ($1.8M, $207 avg paid/claim; ranks #6 of 26, 80th percentile) and 81420 ($1.8M, $299 avg paid/claim; ranks #5 of 15, 71th percentile), showing the operation captures both volume‑driven routine work and mid‑to‑high priced genetic testing.

The provider shows significant public health and infectious disease testing volume: U0003 (COVID NAAT) has 138.8K claims with $36 avg paid/claim for $5M revenue (12.3%), and sexually transmitted infection testing appears at scale with 87591 (363.1K claims, $2.5M, 6.2%) and 87491 (361.2K claims, $2.5M, 6.2%). These counts and revenue lines suggest contractual relationships or referral flows tied to public‑health screening and surveillance programs.

Operating scale is supported by longevity: the NPI was enumerated 2005-05-23 (~21 years ago), indicating an established presence in the market. Coupled with the high claim volumes and repeated top‑rank positions across many codes, this tenure signals an entrenched lab network rather than a new entrant.

From a payer‑strategy perspective, the combination of very large claim volumes at low per‑claim payments and concentrated revenue in a few codes gives this provider both leverage and exposure: leverage in Medicaid negotiations due to outlier state‑level volumes for core panels, but exposure if policy or reimbursement changes reduce payments for those concentrated codes. Analysts should monitor utilization trends and any state policy shifts for high‑share codes (the top 3 represent 26.7% of Medicaid revenue) to assess near‑term revenue sensitivity.

Medicaid: Complete Services Breakdown

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

490 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…	138,780	$40	$5M
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.	984,100	$1	$3M
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…	76,920	$40	$2.9M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	363,060	$10	$2.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	361,190	$10	$2.5M
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…	829,970	$1	$2.5M
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.	1,207,120	$1	$2.4M
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…	478,300	$10	$2.4M
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…	1,133,120	$1	$2.3M
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…	8,700	$210	$1.8M

Showing 1–10 of 490

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Laboratory Corporation Of America — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

490 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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,…	5	20	240	$400	$13.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	298	330	6,130	$130	$2.7M
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…	6	30	170	$260	$2.6M
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…	6	160	840	$70	$2.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	288	320	6,160	$120	$2.1M
81229	The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by…	10	10	680	$480	$1.9M
87902	The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus.	4	10	1,360	$150	$1.8M
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…	57	110	1,450	$110	$1.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	266	280	2,690	$130	$1.6M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	3	40	480	$40	$1.4M

Showing 1–10 of 490

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
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$0	$264.7M
Alamance Regional Medical Center, Inc.	NC	General Acute Care Hospital	$0	$30.8M
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$490.7K	$15.6M
Pinnacle Family Services Of North Carolina LLC	NC	Community/Behavioral Health Agency	$0	$12M
Alpha Diagnostics, LLC	NC	Clinical Medical Laboratory	$11M	$1M
A.r.t. Home Care, LLC	NC	In Home Supportive Care Agency	$0	$10M
Rha Behavioral Health Nc LLC	NC	Community/Behavioral Health Agency	$0	$10M
International Family Clinic	NC	Pediatrics Physician	$0	$8.5M
Grove Park Pediatrics	NC	Pediatrics Physician	$0	$8.5M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$8.1M

Laboratory Corporation Of America — 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