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NPI 1114963956 · Portland, OR · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Portland, Oregon. This profile covers 25 Medicare and 257 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 | Quest Diagnostics Clinical Laboratories Inc |
| Address | 5220 Ne 122nd Ave |
| City | Portland |
| State | OR |
| ZIP | 97230 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $21.8M |
| Medicare | $226.9K |
Payer mix is heavily skewed to Medicaid: the provider reports Total Medicare revenue of $226.9K vs Total Medicaid revenue of $21.8M, meaning Medicaid is by far the dominant payer on-record for this NPI. This is effectively a Medicaid-first billing profile rather than a balanced Medicare/Medicaid mix.
Medicare revenue is concentrated in a small set of pathology and cytology services — the top 3 Medicare codes account for 76.9% of this provider's total Medicare revenue, driven by 88305, G0145, and 87624. Those three codes are specialized pathology/cytology/HPV tests, so the Medicare business appears focused on surgical pathology review and cervical/HPV screening rather than routine chemistry panels.
Although Medicare receipts are concentrated, absolute Medicare scale is small: 88305 alone generates $124.3K (and ranks #1006 of 14580 nationally at the 93th percentile), while G0145 and 87624 also sit in the upper national percentiles (81th and 87th respectively), indicating respectable national positioning on those specific services but modest overall Medicare revenue.
Medicaid billing shows high-volume infectious-disease and population screening testing: the top 3 Medicaid codes (87491, 87591, U0003) account for 23.1% of the provider's Total Medicaid revenue, reflecting heavy NAAT-based testing for chlamydia, gonorrhea, and SARS-CoV-2 in the Medicaid population. Both 87491 and 87591 rank #3 of 72 in-state at the 97th percentile (notably above typical state volume for these codes), while U0003 ranks #7 of 60 at the 90th percentile (typical, unremarkable volume for this code).
Beyond infectious testing, the Medicaid portfolio includes large-volume routine and specialty panels that mark the provider as a high-throughput reference lab at the state level: 80053 (CMP) has $954.2K revenue and ranks #4 of 135 in-state (98th percentile; extreme outlier, far above typical state volume for this code), 80061 (lipid panel) is listed as an extreme outlier state volume, and 81420 (cfDNA prenatal panel) contributes $936K while ranking #1 of 4 in-state (100th percentile; typical, unremarkable volume for this code).
State-level competitive standings show the provider as a major Medicaid participant: multiple codes rank in the top 3 or top percentile bands (e.g., 87491 and 87591 at 97th percentile, 83036 and 82306 also in the 97–99th percentile range), which signals market strength in Oregon Medicaid for both infectious disease NAATs and routine/high-volume chemistry tests. By contrast, the Medicare footprint is specialized but limited in dollar scale.
The overall code mix—surgical pathology (88305), cytology screening (G0145, 88175), HPV and STI NAATs (87624, 87491, 87591), high-throughput panels (80053, 80061), and genomic prenatal testing (81420)—is consistent with a centralized reference laboratory that services large outpatient and public-health screening volumes rather than point-of-care or small hospital laboratory workflows. This breadth across high-volume screening, confirmatory NAATs, and specialty genomic tests suggests diversified service lines within a single laboratory platform.
The provider has long tenure on file (NPI enumerated 2006-06-21 (~20 years ago)), which, combined with elevated in-state rankings and several codes labeled as "notably above typical" or "extreme outlier," points to an established, high-throughput operation with Medicaid-oriented scale that would be a primary target in state-level network contracting and utilization analyses.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 3,270 | $40 | $124.3K |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under… | 1,060 | $30 | $27.4K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 690 | $30 | $23.4K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 130 | $70 | $9.3K |
| 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… | 340 | $30 | $8.8K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 100 | $70 | $7.1K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 60 | $90 | $5.3K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 160 | $20 | $3.6K |
| G0123 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision | 150 | $20 | $2.9K |
| G0124 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician | 110 | $20 | $2.7K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 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.
257 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 55,620 | $20 | $1.2M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 55,530 | $20 | $1.2M |
| 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… | 15,920 | $70 | $1.1M |
| 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. | 136,310 | $10 | $954.2K |
| 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,… | 1,950 | $480 | $936K |
| 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… | 71,270 | $10 | $783.9K |
| 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. | 96,500 | $10 | $772K |
| 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… | 10,130 | $70 | $698.8K |
| 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… | 34,740 | $20 | $694.9K |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 6,740 | $90 | $633.8K |
Showing 1–10 of 257
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
257 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,… | 1 | 10 | 1,200 | $690 | $770.6K |
| 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… | 7 | 60 | 420 | $60 | $405.1K |
| 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… | 5 | 10 | 290 | $90 | $379.1K |
| 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… | 6 | 20 | 780 | $30 | $360.1K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 1 | 10 | 180 | $490 | $359.5K |
| 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… | 7 | 60 | 460 | $40 | $327.4K |
| 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. | 12 | 80 | 1,210 | $40 | $294.3K |
| 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… | 16 | 90 | 530 | $50 | $281.6K |
| 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,… | 2 | 10 | 370 | $300 | $259.6K |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 4 | 10 | 390 | $120 | $240.6K |
Showing 1–10 of 257
Other providers in the same ZIP code as Quest Diagnostics Clinical Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Kaiser Foundation Health Plan Of The Northwest | OR | Clinical Medical Laboratory | $174.4K | $61.7M |
| Albertina Kerr Centers | OR | Community/Behavioral Health Agency | $0 | $15M |
| Apria Healthcare LLC | OR | Durable Medical Equipment & Medical Supplies | $0 | $9.4M |
| Kan-di-ki, LLC | OR | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | $82.1K | $268K |
| Walgreen Co | OR | Pharmacy | $58.6K | $70 |
| Carmen Winters | OR | Anatomic Pathology & Clinical Pathology Physician | $36.7K | $0 |
| Zheru Liu | OR | Anatomic Pathology & Clinical Pathology Physician | $630 | $0 |
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