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NPI 1124536107 · Shelton, CT · Clinical Medical Laboratory
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Esoterix Genetic Laboratories, LLC is a clinical medical laboratory provider located in Shelton, Connecticut. This profile covers 36 Medicare and 35 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 | Esoterix Genetic Laboratories, LLC |
| Address | 3 Forest Pkwy |
| City | Shelton |
| State | CT |
| ZIP | 06484 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 12, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.2M |
| Medicare | $2.2M |
ESOTERIX GENETIC LABORATORIES, LLC operates primarily as a diagnostic clinical laboratory focused on flow cytometry, cytogenetics and targeted genomic panels; its top billed services include flow cytometry add-on and core markers (88185, 88184, 88189), multiple FISH/karyotype cytogenetics codes (88275, 88271, 88264) and targeted sequencing panels (81450, 81455, 81206). The mix of high-volume immunophenotyping and cytogenetic codes alongside mid-volume molecular panels indicates a lab that services both routine hematopathology workflows and higher-complexity genetic testing vectors used in oncology and inherited-disease workups.
Medicare revenue is concentrated: the top three Medicare codes account for 41.9% of this provider's total Medicare revenue. Notably, 88185 alone generates $556.4K (26.3% of Medicare revenue) and ranks #15 of 618 providers nationally (98th percentile, described as notably above typical national volume); 88275 contributes $170.1K (8.0%) and ranks #4 of 72 (96th percentile), while 81450 adds $158.5K (7.5%) and ranks #15 of 48 (70th percentile).
Medicaid billing is even more concentrated: the top three Medicaid codes account for 56.9% of this provider's total Medicaid revenue. In Medicaid, 88185 is the dominant single driver with $1.1M (35.7% of Medicaid revenue) and ranks #2 of 10 in-state (89th percentile), followed by 81220 at $362.5K (11.4%) rank #3 of 9 (75th percentile) and U0003 at $307K (9.7%) rank #21 of 46 (56th percentile).
The provider’s payer mix skews toward Medicaid in scale: reported Medicaid revenue is $3.2M compared with $2.2M in Medicare, so Medicaid represents the larger single payer relationship while Medicare remains a meaningful revenue source. This dual-payer footprint suggests the lab serves both Medicaid-heavy clinical pathways (including newborn/CFTR and state public testing programs) and Medicare oncology/hematology workflows.
ESOTERIX is a competitive volume player on several laboratory-specific services at national and state levels. For Medicare, multiple codes show upper-percentile national rankings—88185 (98th), 88341 (99th), and 88271 (96th)—supporting characterization as a high-volume national performer in flow cytometry, immunohistochemistry, and cytogenetics; in-state Medicaid ranks include #1 or top positions for several codes (88360 #1 of 15, 88275 #1 of 2, 81207 #1 of 3, 81270 #1 of 3), indicating leadership or unique offerings within Connecticut for selected tests.
Some service lines appear unique or relatively exclusive in-state: 81450 for a 5–50 gene hematolymphoid panel is reported in Medicaid as $23.9K and ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), implying ESOTERIX may be the only in-state Medicaid reporter for that panel. That exclusivity, combined with high-volume cytometry and cytogenetics, suggests the lab captures specialized referrals and niche genetic testing demand locally.
The lab’s Medicaid portfolio includes a substantial SARS‑CoV‑2 testing footprint: U0003 shows 5K claims and $307K in Medicaid revenue (9.7% of Medicaid revenue), and U0005 also appears ($33.3K, 1.1%). These volumes indicate the provider supported high-throughput COVID PCR testing for Medicaid populations in the measurement period alongside its oncology/hematology services.
ESOTERIX’s billing tenure is relatively recent but established: NPI enumerated 2018-01-12 (~8 years ago). Achieving $2.2M in Medicare and $3.2M in Medicaid over this span, with multiple top-percentile ranks, suggests rapid scale-up in both routine hematopathology testing and higher-complexity genetic diagnostics since enumeration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
36 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 26,490 | $20 | $556.4K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 3,470 | $50 | $170.1K |
| 81450 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes known to impact… | 210 | $740 | $158.5K |
| 81455 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as tumor tissue or bone marrow, for DNA and possibly RNA alterations in 51 or more genes known to… | 50 | $2,860 | $145.9K |
| 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… | 2,640 | $50 | $124.2K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 5,410 | $20 | $113.7K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 670 | $140 | $94.2K |
| 81206 | The lab analyst performs the technical lab test to evaluate the major breakpoint gene sequence BCR/ALB1 that occurs on chromosome 22 due to translocation, which involves breakage and reforming of an… | 540 | $160 | $87.4K |
| 81207 | The lab analyst performs the technical lab test to evaluate the minor breakpoint gene sequence BCR/ALB1 that occurs on chromosome 22 due to translocation, which involves breakage and reforming of an… | 550 | $140 | $77.4K |
| 88264 | The analyst performs a chromosome analysis and analyzes 20 to 25 cells. The analysis includes counting the number of chromosomes in each cell and preparing a karyotype for each cell examined. | 540 | $140 | $76.2K |
Showing 1–10 of 36
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 36 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
36 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 88185 | 3 | 10 | 32,650 | $20 | $642.3K |
| 88377 | 2 | 10 | 30 | $300 | $134.4K |
| 81455 | 1 | 10 | 50 | $2,860 | $131.6K |
| 88275 | 1 | 10 | 1,910 | $50 | $106.1K |
| 81450 | 1 | 10 | 130 | $740 | $96K |
| 88271 | 1 | 10 | 4,250 | $20 | $82.1K |
| 88184 | 3 | 10 | 1,290 | $60 | $81.1K |
| 88237 | 1 | 10 | 460 | $140 | $64K |
| 88264 | 1 | 10 | 460 | $140 | $55.3K |
| 81207 | 1 | 10 | 330 | $140 | $46.7K |
Showing 1–10 of 36
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.
35 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 6,220 | $180 | $1.1M |
| 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… | 1,150 | $320 | $362.5K |
| 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… | 5,030 | $60 | $307K |
| 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… | 4,060 | $60 | $251.7K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 3,890 | $30 | $116.7K |
| 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,… | 1,440 | $80 | $110.6K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 6,210 | $20 | $105.6K |
| 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,… | 6,280 | $10 | $87.9K |
| 88360 | The lab analyst applies a 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, evaluates the… | 3,250 | $30 | $84.4K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 2,200 | $40 | $83.6K |
Showing 1–10 of 35
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
35 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… | 21 | 50 | 3,340 | $60 | $1M |
| 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… | 62 | 90 | 3,980 | $40 | $424.8K |
| 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… | 3 | 10 | 620 | $200 | $374.6K |
| 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,… | 28 | 50 | 4,960 | $20 | $273.9K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 2 | 10 | 650 | $80 | $188.6K |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 2 | 10 | 630 | $60 | $132.7K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 2 | 10 | 2,390 | $60 | $100.2K |
| 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,… | 2 | 10 | 670 | $40 | $100K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 21 | 40 | 1,210 | $30 | $99.6K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 1 | 10 | 2,140 | $40 | $89.2K |
Showing 1–10 of 35
Other providers in the same ZIP code as Esoterix Genetic Laboratories, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Pediatric Services Of America, LLC | CT | Home Health Agency | $0 | $92.9M |
| Adult Day Care Of America, Inc. | CT | In Home Supportive Care Agency | $0 | $35.1M |
| Dianon Systems, Inc | CT | Clinical Medical Laboratory | $4.9M | $8.5M |
| Option Care Enterprises, Inc | CT | Home Infusion Therapy Pharmacy | $0 | $13.3M |
| Ameripath New York LLC | CT | Clinical Medical Laboratory | $2.9M | $7.7M |
| Enzo Clinical Labs, Inc. | CT | Clinical Medical Laboratory | $0 | $3.8M |
| Bridgeport Radiological Associates LLC | CT | Diagnostic Radiology Physician | $0 | $2.9M |
| Shelton Pediatrics | CT | Pediatrics Physician | $0 | $2.7M |
| Echo Hose Hook And Ladder Ambulance Corps., Inc. | CT | Land Ambulance | $568.5K | $1.7M |
| Shelton Dental Group LLC | CT | Dentist | $0 | $2.1M |
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