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NPI 1184041949 · Brunswick, GA · Clinical Medical Laboratory
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Paradigm Labs, LLC is a clinical medical laboratory provider located in Brunswick, Georgia. This profile covers 5 Medicare and 17 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 | Paradigm Labs, LLC |
| Address | 1302 Fountain Park Circle |
| City | Brunswick |
| State | GA |
| ZIP | 31520 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | March 18, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $19.6M |
| Medicare | $3.1M |
PARADIGM LABS, LLC reports $3.1M in total Medicare revenue and $19.6M in total Medicaid revenue, indicating Medicaid is the materially larger payer relationship for this entity. The two-payer footprint is therefore Medicaid-dominant by scale, with the provider generating the majority of its lifetime public-pay revenue from state Medicaid rather than Medicare.
The provider’s code mix is overwhelmingly concentrated in definitive and presumptive drug testing: G0480, G0481, G0482, G0483 and 80307 are the visible drivers in both payers. These codes describe GC/MS and LC/MS definitive drug identification with specimen validity testing as well as instrumented presumptive screens, consistent with an operation configured as a high-throughput clinical toxicology/forensic testing laboratory rather than a general diagnostic lab.
Medicare revenue is highly concentrated: the top three Medicare codes (G0480, G0481, 80307) account for 87.5% of the provider’s Medicare revenue. Those three codes individually contribute $1.4M (44.3%) for G0480, $823.7K (26.5%) for G0481, and $519.4K (16.7%) for 80307, and each ranks at the extreme high end nationally (G0480 #8 of 1590, 100th percentile, extreme outlier; G0481 #9 of 1766, 100th percentile, extreme outlier; 80307 #27 of 4760, 99th percentile, extreme outlier).
Medicaid revenue is also concentrated in high-complexity drug testing: the top three Medicaid codes (G0483, G0482, G0480) together account for 76.1% of the provider’s Medicaid revenue. Those codes produce $6.6M (33.5%) from G0483, $4.3M (22.0%) from G0482, and $4M (20.6%) from G0480; each ranks near the top among in-state peers (G0483 #2 of 29, 96th percentile, notably above typical state volume; G0482 #2 of 26, 96th percentile, notably above typical state volume; G0480 #2 of 34, 97th percentile, notably above typical state volume).
Competitive standing differs by payer: for Medicare PARADIGM LABS is a national outlier on definitive drug-testing codes (G0480 and G0481 at the 100th percentile labeled extreme outlier; 80307 at the 99th percentile), reflecting volumes far above typical national providers for those services. In Medicaid the provider is a leading in-state volume performer on the same code family (multiple #2 rankings and 92–97th percentile placements), indicating a strong regional position for high-complexity toxicology testing.
Reimbursement levels differ across payers for the same services: on Medicare the top definitive codes show higher per-claim averages than Medicaid for equivalent codes (examples: G0483 $242 avg paid/claim on Medicare vs $174 on Medicaid, G0482 $195 vs $129, G0480 $111 vs $50, and G0481 $152 vs $84). This pattern suggests the provider achieves both higher unit reimbursement and high volumes on Medicare for selected definitive tests while Medicaid generates the bulk of total dollars through much larger claim volumes.
Volume metrics confirm a throughput-focused operation, with large claim counts reported especially on Medicaid: G0480 has 80.8K Medicaid claims and 12.4K Medicare claims, G0483 has 37.7K Medicaid claims versus 332 Medicare claims, and G0482 has 33.5K Medicaid claims versus 1.6K Medicare claims. Those counts, coupled with multi-million-dollar Medicaid revenues (e.g., $6.6M for G0483 and $4.3M for G0482), reinforce that the provider’s business model relies on high-volume toxicology testing for state programs.
The provider’s NPI was enumerated on 2014-03-18 (~12 years ago), indicating an established operating history; combined with its concentrated code mix, high claim volumes, and high in-state and national percentiles, this suggests a sustained specialized laboratory presence focused on drug-testing services rather than a broad outpatient diagnostic offering.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 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… | 12,390 | $110 | $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… | 5,420 | $150 | $823.7K |
| 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. | 8,520 | $60 | $519.4K |
| 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… | 1,570 | $200 | $306.7K |
| 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… | 330 | $240 | $80.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
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.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 37,740 | $170 | $6.6M |
| 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… | 33,520 | $130 | $4.3M |
| 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… | 80,850 | $50 | $4M |
| 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. | 64,310 | $50 | $3.1M |
| 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… | 19,060 | $80 | $1.6M |
| 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… | 60 | $30 | $1.5K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 50 | $20 | $870 |
| 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. | 40 | $10 | $510 |
| 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).… | 60 | $10 | $440 |
| 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… | 40 | $10 | $310 |
Showing 1–10 of 17
How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Georgia median
17 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… | 2 | 30 | 2,370 | $100 | $757.4K |
| 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… | 10 | 10 | 140 | $20 | $529.9K |
| 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… | 2 | 30 | 860 | $70 | $525.3K |
| 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… | 2 | 30 | 940 | $30 | $467.9K |
| 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. | 3 | 70 | 2,840 | $30 | $428.7K |
| 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… | 3 | 30 | 1,130 | $50 | $338.3K |
| 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… | 38 | 40 | 180 | $20 | $194.3K |
| 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… | 41 | 50 | 760 | $10 | $164.2K |
| 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. | 78 | 100 | 460 | $10 | $159.9K |
| 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. | 66 | 80 | 600 | $10 | $110.4K |
Showing 1–10 of 17
Other providers in the same ZIP code as Paradigm Labs, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gateway Community Service Board | GA | Community/Behavioral Health Agency | $0 | $22.4M |
| Emergency Physicians Inc | GA | Emergency Medicine Physician | $0 | $7.6M |
| Arc Of Georgia, LLC | GA | Ambulatory Surgical Clinic/Center | $1.3M | $0 |
| Emmanuel Gage | GA | Interventional Pain Medicine Physician | $1.1M | $0 |
| Seaside Surgical, LLC | GA | Ophthalmologic Surgery Clinic/Center | $1M | $0 |
| Diana L. Walther, Ph.d. PC | GA | Psychologist | $0 | $841.2K |
| Edward Dipreta | GA | Dermatology Physician | $584.1K | $0 |
| Ahmed Elsharkawi | GA | Nephrology Physician | $497K | $0 |
| Mark Watkins | GA | Specialist | $485.6K | $0 |
| Bonnie Brooks | GA | Ophthalmology Physician | $448.3K | $0 |
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