Loading...
NPI 1255889473 · San Bernardino, CA · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Orange Toxicology Lab Inc. is a clinical medical laboratory provider located in San Bernardino, California. This profile covers 5 Medicare and 10 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 | Orange Toxicology Lab Inc. |
| Address | 1535 S D St Fl 2 |
| City | San Bernardino |
| State | CA |
| ZIP | 92408 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 16, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $14.1M |
| Medicaid | $337.8K |
ORANGE TOXICOLOGY LAB INC. appears to be primarily a COVID-19 testing operation: its top Medicare revenue driver is K1034 (Provision of covid-19 test, nonprescription self-administered and self-collected use) with 1.2M claims and $14.3M revenue, and other leading Medicare and Medicaid codes (U0003, U0005, G2023, 87635) describe high-throughput SARS‑CoV‑2 NAATs and specimen collection. The code mix suggests the business model centers on mass distribution and processing of SARS‑CoV‑2 tests rather than a broad, diversified clinical-lab test menu.
Revenue is highly concentrated on a small set of COVID-related codes: the top 3 Medicare codes account for 99.7% of the provider’s Medicare revenue, and K1034 alone represents 98.9% of that Medicare total. On Medicaid the top 3 codes account for 90.7% of the provider’s Medicaid revenue, underscoring that both payers’ activity is dominated by a few test types.
Payer mix is heavily Medicare-weighted in scale: lifetime Medicare revenue is $14.1M compared with $337.8K in lifetime Medicaid revenue, indicating the business is effectively Medicare-dominant by dollars. Medicaid activity exists but is a small fraction of overall lifetime revenue, so changes in Medicare reimbursement or demand will have outsized impact on overall revenue.
K1034 is a statistical outlier nationally for Medicare: the provider ranks #35 of 30143 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), which signals dominant national volume for that specific nonprescription/self-administered COVID test product. By contrast other Medicare codes (U0003, U0005, G2023, 87635) are described as typical or unremarkable volumes and have mid-to-high but not exceptional ranks (for example U0003 ranks #189 of 973 providers nationally (81th percentile; typical, unremarkable volume)).
Within Medicaid the provider’s competitive standing for SARS‑CoV‑2 testing is modest-to-typical in-state: U0003 accounts for $217.7K (64.7% of Medicaid revenue) and ranks #209 of 751 in-state (72th percentile; typical, unremarkable volume), while G2023 accounts for $55.9K (16.6%) and ranks #134 of 497 in-state (73th percentile; typical, unremarkable volume). The Medicaid position shows meaningful service volume but not the same market dominance observed nationally for K1034 on Medicare.
Several billed Medicaid codes show claims with $0 reported paid (for example K1034: 1.5K claims, $0 revenue; G0480: 22 claims, $0 revenue; 87641: 20 claims, $0 revenue; 87798: 20 claims, $0 revenue), which is consistent with non-reimbursed distribution or zero-dollar billing for certain test products or specimen types rather than high-dollar Medicaid reimbursements. Analysts should treat those claim counts and $0 payments as an operational signal (volume of transactions) distinct from revenue generation.
The provider’s Medicare revenue profile creates concentration risk and opportunity: because $14.1M of lifetime Medicare revenue is driven almost entirely by a single product code (K1034 at $14.3M), the entity is operationally exposed to changes in policy, reimbursement, or demand for that nonprescription, self-administered COVID test. Conversely, the facility’s extreme national scale on that code could be leveraged into negotiated contracts or partnerships if payers or public programs seek high-volume suppliers.
The entity has been enumerated for a substantial period: NPI enumerated 2016-09-16 (~10 years ago), indicating an established billing presence. That tenure combined with the high-volume K1034 activity suggests the organization has built scale and operational processes around SARS‑CoV‑2 test distribution and reporting over multiple years.
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 |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,189,770 | $10 | $14.3M |
| 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… | 1,090 | $70 | $80.9K |
| 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,… | 1,090 | $30 | $27.3K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1,100 | $20 | $25.3K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 500 | $50 | $24.9K |
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 3,160 | $70 | $217.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 3,110 | $20 | $55.9K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 680 | $50 | $31.2K |
| 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,… | 1,900 | $20 | $30.4K |
| 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… | 160 | $10 | $810 |
| 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. | 180 | $1 | $180 |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 20 | $0 | $0 |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 20 | $0 | $0 |
| 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… | 20 | $0 | $0 |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,540 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
10 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… | 66 | 100 | 520 | $120 | $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… | 209 | 750 | 950 | $50 | $890K |
| 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. | 524 | 660 | 1,490 | $30 | $417.2K |
| 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… | 323 | 340 | 970 | $40 | $343.6K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 134 | 500 | 530 | $20 | $128.1K |
| 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,… | 162 | 520 | 470 | $10 | $116K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 508 | 1,210 | 420 | $30 | $95.7K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 346 | 400 | 330 | $20 | $67.9K |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 120 | 130 | 330 | $10 | $10.9K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 8 | 50 | 120 | $1 | $3.4K |
Other providers in the same ZIP code as Orange Toxicology Lab Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Sac Health System | CA | Federally Qualified Health Center (FQHC) | $0 | $50.6M |
| Premier Healthcare Services, LLC | CA | Home Health Agency | $0 | $38.9M |
| Maxim Healthcare Services, Inc. | CA | Home Health Agency | $0 | $30.2M |
| Colton Ca Multi Asc LP | CA | Ambulatory Surgical Clinic/Center | $618.5K | $679.5K |
| David Gennis | CA | Marriage & Family Therapist | $109.8K | $2.6K |
| Fariborz Lalezarzadeh | CA | Surgery Physician | $43.1K | $43.8K |
| Minh-tri Nguyen | CA | Transplant Surgery Physician | $84.8K | $0 |
| Sunitha Nune | CA | Sleep Medicine (Psychiatry & Neurology) Physician | $3.1K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.