Loading...
NPI 1114435492 · Nicholasville, KY · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Dx Solutions, LLC is a clinical medical laboratory provider located in Nicholasville, Kentucky. This profile covers 139 Medicare and 174 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 | Dx Solutions, LLC |
| Address | 110 Dewey Dr Ste A |
| City | Nicholasville |
| State | KY |
| ZIP | 40356 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 20, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $24.9M |
| Medicare | $1.9M |
DX SOLUTIONS, LLC is a clinical medical laboratory whose Medicare portfolio shows a mix of routine chemistry and hematology testing alongside specimen-collection services, while its Medicaid billing is heavily concentrated in high-throughput molecular infectious-agent testing. Medicare top revenue codes include P9603, 80053, and 85025 (claims and revenue reported), indicating routine CMP/CBC testing and travel allowance billing; Medicaid top codes U0003, 87798, and U0005 show a molecular/COVID testing orientation at scale.
The provider's payer mix is heavily skewed toward Medicaid in dollar terms: total Medicaid revenue is $24.9M compared with total Medicare revenue of $1.9M, so Medicaid accounts for the clear majority of reported lifetime public-payor revenue for this entity. This makes the provider effectively a Medicaid-centric laboratory for revenue impact and state-level contracting considerations.
Medicaid revenue is highly concentrated: the top three Medicaid codes account for 80.2% of the provider's total Medicaid revenue, led by U0003 at 369.5K claims and $12.9M revenue (55.7%), followed by 87798 at 27K claims and $3.3M revenue (14.2%), and U0005 at 217.3K claims and $2.4M revenue (10.3%). This concentration shows that a single service line—high-throughput nucleic-acid infectious-agent testing—drives most Medicaid dollars.
Medicare revenue shows more distribution among routine lab services but still has concentration: the top three Medicare codes account for 30.4% of total Medicare revenue, with P9603 reported at 207.1K claims and $207.1K revenue (12.3%), 80053 at 15.3K claims and $152.8K revenue (9.1%), and 85025 at 18.9K claims and $151.5K revenue (9.0%). That mix indicates traditional clinical laboratory work (CMPs, CBCs) paired with notable specimen-collection travel charges.
Competitively at the state level, DX SOLUTIONS is a dominant provider for SARS‑CoV‑2 molecular testing: U0003 and U0005 both rank #1 in-state (100th percentile) and are labeled “extreme outlier, far above typical state volume,” while 87798 ranks #3 in-state (97th percentile, notably above typical). These rankings indicate the provider is a major in-state source for high-volume molecular testing and specimen processing.
On Medicare-national competitive standing, many routine lab codes show very high percentiles but are often described as “typical, unremarkable volume” (for example, 80053 at the 99th percentile and 85025 at the 100th percentile), meaning the provider reports large absolute volumes yet within expected patterns for clinical labs; however, code 80047 (rank #10, 99th percentile) is explicitly marked as an “extreme outlier, far above typical national volume,” and 87186 and 85610 are noted as “notably above typical,” signaling particular national-level concentration in select assays.
Operationally, the provider’s Medicare billing includes large counts for specimen‑collection travel allowances with P9603 at 207.1K claims and P9604 at 8.9K claims, which suggests capacity for mobile or home/nursing‑home specimen collection and related logistics. Combined with the Medicaid high-throughput molecular volumes (U0003 and U0005), the overall footprint points to both centralized molecular testing capacity and distributed specimen collection capabilities.
DX SOLUTIONS’ NPI was enumerated 2018-01-20 (~8 years ago), establishing several years of claims history. Given the extreme state-level concentration in a few molecular codes and the Medicare outlier signals on specific panels and collection fees, payers and provider analysts should monitor contract terms, capacity, and coding consistency for the high-volume molecular lines and for the high-frequency specimen-collection activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
139 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 | 207,100 | $1 | $207.1K |
| 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. | 15,280 | $10 | $152.8K |
| 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… | 18,930 | $10 | $151.5K |
| 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… | 8,960 | $20 | $143.4K |
| 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… | 3,890 | $30 | $112.8K |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 8,860 | $10 | $97.4K |
| 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. | 7,470 | $10 | $97.1K |
| 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… | 1,250 | $70 | $92.8K |
| 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… | 11,510 | $10 | $92.1K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 14,470 | $10 | $86.8K |
Showing 1–10 of 139
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 139 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
174 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… | 369,510 | $40 | $12.9M |
| 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… | 26,970 | $120 | $3.3M |
| 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,… | 217,260 | $10 | $2.4M |
| 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… | 5,490 | $220 | $1.2M |
| 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)… | 6,130 | $60 | $373.7K |
| 80074 | The lab analyst performs an acute hepatitis panel; the panel must include tests for hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody. | 15,190 | $20 | $258.3K |
| 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… | 25,260 | $10 | $227.4K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 7,920 | $30 | $205.9K |
| 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. | 64,450 | $1 | $193.4K |
| 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… | 36,080 | $10 | $180.4K |
Showing 1–10 of 174
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
174 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0482 | 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… | 37 | 50 | 2,830 | $90 | $1.4M |
| 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… | 50 | 80 | 990 | $60 | $912.2K |
| 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. | 178 | 340 | 2,700 | $40 | $673.3K |
| G0480 | 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… | 80 | 140 | 2,000 | $60 | $639.8K |
| 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 | 110 | 2,280 | $50 | $552.6K |
| 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… | 21 | 70 | 310 | $100 | $495.2K |
| 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)… | 9 | 50 | 570 | $110 | $393.6K |
| 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. | 34 | 200 | 16,730 | $10 | $365.9K |
| 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… | 6 | 80 | 260 | $270 | $358.5K |
| 87632 | The lab analyst performs a test to identify a respiratory virus using an amplified nucleic acid probe technique. He may also use the multiplex reverse transcription technique. The provider does this… | 2 | 10 | 650 | $160 | $261.3K |
Showing 1–10 of 174
Other providers in the same ZIP code as Dx Solutions, LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.