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NPI 1174504989 · Bismarck, ND · Clinical Medical Laboratory
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Northern Plains Laboratory, LLC is a clinical medical laboratory provider located in Bismarck, North Dakota. This profile covers 177 Medicare and 71 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 | Northern Plains Laboratory, LLC |
| Address | 401 N 9th St |
| City | Bismarck |
| State | ND |
| ZIP | 58501 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 9, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.2M |
| Medicare | $960.2K |
Medicare billing is concentrated in routine phlebotomy and chemistry panels: the top Medicare revenue drivers are 36415, 80053, and 80061, which correspond to venipuncture, comprehensive metabolic panel, and lipid panel testing. This mix indicates the provider operates as a general clinical laboratory with strong outpatient specimen collection and high-throughput chemistry testing rather than a narrowly specialized reference lab.
Revenue concentration is meaningful on both payers: the top three Medicare codes account for 33.6% of the provider's Medicare revenue and the top three Medicaid codes account for 25.4% of the provider's Medicaid revenue. Those precomputed shares, combined with reported lifetime totals of $960.2K in Medicare revenue and $1.2M in Medicaid revenue, show a small number of tests disproportionately contribute to overall receipts.
The provider maintains a dual-payer footprint with Medicaid slightly larger in scale than Medicare: lifetime Medicaid revenue is $1.2M versus $960.2K in Medicare. This makes the entity neither single-payer dependent nor dominated by Medicare, but it does rely materially on both payers for volume and revenue.
Against national Medicare peers this lab posts very high-ranking volumes on common tests: 36415 ranks at the 100th percentile nationally and 80053 and 80061 sit in the 99th percentile range. The dataset labels these as "typical, unremarkable volume" despite the high percentiles, which suggests the practice has strong throughput for routine panels consistent with many high-volume community laboratories rather than an unusual specialty profile.
Within North Dakota Medicaid comparisons the lab is a leading in-state performer on infectious disease NAAT and point-of-care targets: 87491 and 87591 rank #2 in-state (95th and 94th percentiles) and codes 87480, 87510, and 87660 rank #1 in-state (100th percentile) for Candida, Gardnerella, and Trichomonas testing. These rankings and the Medicaid revenue attributed to those codes indicate the provider is a major local source for sexually transmitted infection and related molecular diagnostics.
Medicare billing includes a nontrivial share of higher-cost molecular and specialty items: 0241U accounts for $26.3K, G0483 for $23.4K, and COVID-related codes such as U0002 appear with $16.1K in revenue, reflecting capacity to perform molecular/definitive drug and infectious-disease testing alongside routine panels. The presence of these codes shows the lab supplements its core chemistry/hematology work with targeted molecular and confirmatory services.
Operational throughput is reflected in high claim counts for routine collection and hematology: 36415 appears with 12.4K Medicare claims and 10.2K Medicaid claims, and 85025 has 8.4K Medicare claims and 8.1K Medicaid claims. Those volumes point to substantial specimen collection activity and recurring CBC orders, consistent with a centralized draw/processing model serving ambulatory providers and public-health testing needs.
The provider has long-standing registration with an NPI enumerated on 2005-11-09 (~21 years ago), indicating established market presence and operational tenure. Despite this longevity, lifetime payer receipts are modest in absolute terms ($960.2K Medicare and $1.2M Medicaid), suggesting a stable regional laboratory operation rather than a large national reference laboratory.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
177 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 12,440 | $10 | $99.5K |
| 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. | 8,240 | $10 | $82.4K |
| 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. | 5,480 | $10 | $71.2K |
| 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… | 8,360 | $10 | $66.9K |
| 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… | 2,180 | $30 | $63.3K |
| 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… | 3,690 | $20 | $59.1K |
| 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).… | 4,210 | $10 | $42.1K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 3,890 | $10 | $31.1K |
| 0241U | N/A | 190 | $140 | $26.3K |
| 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… | 100 | $240 | $23.4K |
Showing 1–10 of 177
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 177 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.
71 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. | 2,520 | $40 | $111K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 2,520 | $30 | $83K |
| 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… | 1,740 | $40 | $72.9K |
| 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… | 3,850 | $20 | $69.3K |
| 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. | 3,510 | $20 | $66.8K |
| 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. | 6,520 | $10 | $65.2K |
| 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… | 1,190 | $50 | $57K |
| 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. | 1,530 | $30 | $51.9K |
| 87480 | The lab analyst performs a test for Candida species using direct nucleic acid probe technique. | 2,130 | $20 | $48.9K |
| 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… | 8,130 | $10 | $48.8K |
Showing 1–10 of 71
How this provider's Medicaid billing volume and revenue compare to other North Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Dakota median
71 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 3 | 10 | 850 | $100 | $2.4M |
| 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… | 9 | 10 | 160 | $60 | $172.1K |
| 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. | 18 | 20 | 920 | $30 | $111.2K |
| 0241U | N/A | 9 | 20 | 200 | $130 | $62.2K |
| 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… | 5 | 10 | 300 | $50 | $53.7K |
| 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. | 13 | 50 | 630 | $10 | $49.4K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 5 | 10 | 240 | $30 | $41.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 2 | 20 | 150 | $50 | $34.6K |
| 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… | 4 | 20 | 170 | $20 | $33K |
| 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. | 3 | 10 | 90 | $50 | $32.3K |
Showing 1–10 of 71
Other providers in the same ZIP code as Northern Plains Laboratory, LLC, ranked by combined Medicare and Medicaid revenue.
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