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NPI 1326104613 · Houston, TX · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Houston, Texas. This profile covers 524 Medicare and 271 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 | Quest Diagnostics Clinical Laboratories Inc |
| Address | 5850 Rogerdale Rd |
| City | Houston |
| State | TX |
| ZIP | 77072 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | December 29, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $31M |
| Medicaid | $8.8M |
Payer mix and scale: This provider has materially larger Medicare activity than Medicaid activity, with lifetime Medicare revenue of $31M versus Medicaid revenue of $8.8M. Both payers show high-volume laboratory services, but Medicare is the dominant revenue source on this profile in absolute dollars.
Medicare revenue concentration: The provider’s top three Medicare codes account for 36.3% of its total Medicare revenue, driven by 36415 ($2.9M, 13.1%), 80053 ($2.8M, 12.8%), and 80061 ($2.3M, 10.4%). This concentration indicates routine specimen collection and high-volume chemistry/panel testing are primary revenue drivers for its Medicare book of business.
Medicaid revenue concentration: The provider’s top three Medicaid codes account for 32.7% of its total Medicaid revenue, with 87491 ($728.8K, 11.2%), 87591 ($721.3K, 11.1%), and 80050 ($674.7K, 10.4%) comprising roughly one-third of Medicaid revenue. This mix highlights a material reliance on infectious disease NAATs for STIs and broad screening panels in the Medicaid population.
Business and service-line implications: The code mix — very large volumes of specimen collection (36415, 364.7K claims), routine panels and metabolic/CBC testing (80053, 80061, 85025) and high volumes of molecular and infectious disease tests (e.g., 87491, 87591, U0003) — is consistent with a centralized, high-throughput clinical laboratory operation that handles both routine screening and specialized reference assays. High counts across automated analyte codes (A1C 83036, vitamin D 82306, TSH 84443) further indicate capacity for both common chronic disease monitoring and specialty endocrine/cardiac testing.
Medicare competitive standing: On Medicare the provider is a national volume leader for many routine lab services — for example 36415 ranks #15 of 86467 providers nationally, 80053 ranks #21 of 26416, and 80061 ranks #22 of 21671; each of these is listed at the 100th percentile and labeled an "extreme outlier, far above typical national volume for this code." These rankings indicate the provider operates at a scale well above typical national peers for specimen collection and common chemistry panels.
Medicaid competitive standing (in-state): The provider shows a strong in-state presence on many panel and screening codes yet a mixed footprint for STI NAATs. Examples include 80053 ranking #5 of 728 providers in-state (99th percentile; extreme outlier, far above typical state volume) and 82306 ranking #6 of 384 (99th percentile), while 87491 and 87591 each rank #11 of ~300 providers in-state (97th percentile) and are characterized as "typical, unremarkable volume" despite large absolute claim counts. This suggests the provider is a major state-level laboratory for core panels and some specialty assays, but STD NAAT volumes are closer to peer norms in-state.
Statistical outliers and specialty capability: Multiple individual codes are flagged as high outliers, indicating concentrated expertise or throughput in specific assays — for example 82306 (vitamin D) and 83036 (A1C) are both described as "extreme outlier" nationally, while 83970 (PTH) and 83880 (natriuretic peptide) also appear far above typical volumes. Those labels point to above-typical capacity for endocrine, metabolic and certain cardiac-related laboratory testing beyond routine panels.
Tenure and operational inference: The NPI was enumerated on 2006-12-29 (~20 years ago), indicating long-tenured billing activity. Coupled with the high-claim counts and national/state percentile standings across many codes, the profile is consistent with an established commercial/central laboratory operator that has built sustained volume and payer relationships over many 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.
524 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. | 364,730 | $10 | $2.9M |
| 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. | 284,030 | $10 | $2.8M |
| 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. | 177,290 | $10 | $2.3M |
| 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… | 143,880 | $20 | $2.3M |
| 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… | 226,440 | $10 | $1.8M |
| 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… | 58,050 | $30 | $1.7M |
| 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).… | 123,970 | $10 | $1.2M |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 24,110 | $40 | $964.4K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 28,170 | $20 | $507.1K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 55,140 | $10 | $496.2K |
Showing 1–10 of 524
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 524 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
524 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87798 | 261 | 300 | 790 | $30 | $265.1K |
| 81450 | 5 | 10 | 30 | $700 | $140K |
| 87900 | 3 | 10 | 50 | $130 | $111.5K |
| 81339 | 12 | 20 | 280 | $180 | $100.3K |
| 81279 | 14 | 20 | 270 | $180 | $86.8K |
| 87801 | 26 | 120 | 170 | $70 | $86.5K |
| G0483 | 152 | 170 | 150 | $240 | $84.9K |
| 83876 | 1 | 10 | 610 | $50 | $80.1K |
| 86003 | 5 | 10 | 8,740 | $10 | $78.5K |
| 87536 | 5 | 10 | 560 | $80 | $75.8K |
Showing 1–10 of 524
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.
271 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. | 45,550 | $20 | $728.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 45,080 | $20 | $721.3K |
| 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… | 42,170 | $20 | $674.7K |
| 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… | 10,320 | $50 | $485K |
| 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. | 186,420 | $1 | $372.8K |
| 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… | 40,340 | $10 | $363K |
| 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… | 67,260 | $10 | $336.3K |
| 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. | 14,300 | $20 | $314.6K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 19,360 | $20 | $290.4K |
| 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… | 120,170 | $1 | $240.3K |
Showing 1–10 of 271
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas median
271 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 6 | 20 | 250 | $40 | $821.3K |
| 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… | 31 | 340 | 400 | $50 | $553.5K |
| 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… | 9 | 30 | 410 | $70 | $363.5K |
| 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 | 150 | 170 | $30 | $302.9K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 13 | 70 | 800 | $20 | $268.3K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 10 | 20 | 1,370 | $40 | $268.3K |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 6 | 30 | 200 | $20 | $262.8K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 6 | 10 | 770 | $140 | $242K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 11 | 290 | 410 | $20 | $225K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 11 | 300 | 410 | $20 | $223.4K |
Showing 1–10 of 271
Other providers in the same ZIP code as Quest Diagnostics Clinical Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Cathy Home Care Ltd | TX | Home Health Agency | $0 | $52M |
| Medical Insights & Care Unlimited, L.P. | TX | Home Health Agency | $0 | $43.8M |
| Golden Years Corporation | TX | Personal Care Attendant | $0 | $29.4M |
| Alief Independent School District | TX | Local Education Agency (LEA) | $0 | $22.9M |
| Kbc Home Healthcare Inc | TX | Personal Care Attendant | $0 | $17.3M |
| Drdolittledentistry PLLC | TX | Dentist | $0 | $11M |
| Jianwei Feng | TX | Cardiovascular Disease Physician | $447.1K | $0 |
| Duc Phan | TX | Internal Medicine Physician | $201K | $0 |
| Thuan Nguyen | TX | Specialist | $62.1K | $13.5K |
| Cuong Trinh | TX | Internal Medicine Physician | $69.2K | $0 |
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