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NPI 1134165970 · Cincinnati, OH · Clinical Medical Laboratory
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Labone Of Ohio Inc is a clinical medical laboratory provider located in Cincinnati, Ohio. This profile covers 273 Medicare and 423 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 | Labone Of Ohio Inc |
| Address | 6700 Steger Dr |
| City | Cincinnati |
| State | OH |
| ZIP | 45237 |
| 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 | $167.2M |
| Medicare | $1.7M |
This provider is heavily Medicaid‑weighted: reported Medicaid revenue is $167.2M versus $1.7M in Medicare, indicating Medicaid drives the vast majority of billed volume and commercial/Medicare-facing activity is relatively small by comparison. The scale difference suggests the provider operates primarily as a Medicaid-serving laboratory rather than a Medicare-focused diagnostic partner.
Revenue concentration is material in both payers: the top 3 Medicare codes by revenue account for 31.6% of this provider's total Medicare revenue, while the top 3 Medicaid codes by revenue account for 40.6% of this provider's total Medicaid revenue. For Medicare the largest individual contributors are G0480, 80053, and 84443; for Medicaid the dominant codes are 80307, G0480, and U0003, showing concentration in a limited set of high-throughput assays.
The code mix points to a laboratory operation focused on toxicology and high‑volume infectious/molecular testing. Dominant Medicaid codes such as 80307 and G0480 reflect presumptive and definitive drug testing at scale, while U0003, 87591, 87491 and 87801 indicate substantial real‑time molecular/SARS‑CoV‑2 and STD testing capacity serving population screening and diagnostic workflows.
Medicare competitive standing is moderate: several top Medicare codes rank in high national percentiles (for example, 80053 at 99th percentile, 84443 at 99th percentile, and G0480 at the 95th percentile) but are described as "typical, unremarkable volume" for the code. This combination implies the lab has meaningful national presence on common clinical panels and analytes without being portrayed as a uniquely dominant national toxicology or esoteric‑assay provider on Medicare.
In contrast, the provider is a major statewide player in Medicaid for multiple assays: 80307 ranks #2 of 343 providers in‑state and is labeled an "extreme outlier," G0480 ranks #1 of 122 providers in‑state ("extreme outlier"), and several other Medicaid codes (87801, 87799, 80362) also show #1 rankings or extreme outlier status. These in‑state rankings indicate the lab is a primary destination for Medicaid‑paid drug screens and molecular testing in Ohio.
The Medicaid code profile (very large counts for 80307, G0480, 80053, 84443, and high volumes for NAAT codes like U0003 and 87591) is consistent with servicing large‑scale screening programs, public health testing, and sustained demand for both presumptive and definitive toxicology. While the data do not specify customers, the mix—high volumes of low‑unit‑price panels and very large counts of drug and NAAT tests—suggests relationships with high‑throughput specimen sources rather than low‑volume specialty referrals.
Operational and reimbursement exposure is concentrated: with the top 3 Medicaid codes accounting for 40.6% of Medicaid revenue and Medicaid outstripping Medicare by two orders of magnitude, changes to state Medicaid coverage, reimbursement, or utilization controls for drug testing and NAATs would materially affect overall revenue. Medicare represents a small revenue base ($1.7M) so policy shifts there would have limited enterprise impact relative to Medicaid.
LABONE OF OHIO INC has an established presence (NPI enumerated 2006-06-21, ~20 years ago), which supports the scale seen in Medicaid volumes and in‑state rankings. Longevity combined with the observed high throughput suggests stable operational capacity and entrenched referral or contractual relationships within Ohio's Medicaid testing ecosystem.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
273 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,300 | $110 | $145.7K |
| 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. | 12,870 | $10 | $128.7K |
| 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… | 7,660 | $20 | $122.5K |
| 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. | 8,900 | $10 | $115.7K |
| 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… | 3,360 | $30 | $97.4K |
| 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. | 1,460 | $60 | $89K |
| 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… | 9,650 | $10 | $77.2K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 7,890 | $10 | $63.1K |
| 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… | 260 | $240 | $61.7K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 5,290 | $10 | $52.9K |
Showing 1–10 of 273
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 273 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.
423 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 597,010 | $30 | $19.7M |
| 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… | 326,500 | $60 | $18M |
| 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… | 114,630 | $70 | $7.6M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 237,850 | $20 | $4.8M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 235,710 | $20 | $4.7M |
| 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… | 67,430 | $70 | $4.7M |
| 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. | 664,130 | $10 | $4.6M |
| 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… | 359,990 | $10 | $4M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 88,490 | $40 | $3.9M |
| 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. | 486,490 | $10 | $3.9M |
Showing 1–10 of 423
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
423 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,… | 2 | 10 | 510 | $320 | $4M |
| 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… | 2 | 140 | 1,130 | $90 | $1.1M |
| 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… | 6 | 80 | 910 | $110 | $884.9K |
| 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… | 5 | 50 | 310 | $110 | $817.2K |
| 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… | 2 | 50 | 220 | $30 | $675.9K |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 2 | 20 | 480 | $50 | $671.8K |
| 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… | 2 | 20 | 170 | $210 | $485.4K |
| 0241U | N/A | 77 | 90 | 1,960 | $120 | $464.3K |
| 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… | 2 | 30 | 480 | $110 | $415.5K |
| 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. | 2 | 340 | 2,260 | $30 | $398.2K |
Showing 1–10 of 423
Other providers in the same ZIP code as Labone Of Ohio Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| St. Joseph Orphanage | OH | Community/Behavioral Health Agency | $0 | $20.1M |
| Sjo Kids Inc | OH | Community/Behavioral Health Agency | $0 | $15.6M |
| St. Aloysius Orphanage | OH | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $13M |
| See More Smiles - Geier Dmd And Amin Dds LLC | OH | Dental Clinic/Center | $0 | $10.9M |
| Care Medical, Inc. | OH | Durable Medical Equipment & Medical Supplies | $0 | $8.4M |
| Ameripath Cincinnati Inc | OH | Clinical Medical Laboratory | $3.2M | $602.7K |
| Ameripath Kentucky Inc | OH | Clinical Medical Laboratory | $118.9K | $22.6K |
| Mary Baker | OH | Family Nurse Practitioner | $90.6K | $0 |
| James Esmail | OH | Clinical Psychologist | $11K | $0 |
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