Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. California (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Myriad Women's Health, Inc. (NPI 1346479169)

Key Findings

Field	Value
Entity Type	Organization
Organization	Myriad Women's Health, Inc.
Address	233 E Grand Ave
City	South San Francisco
State	CA
ZIP	94080
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	July 14, 2009

Payer Source	Total Paid
Medicaid	$146.7M
Medicare	$0

MYRIAD WOMEN'S HEALTH, INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file and total Medicaid revenue is $146.7M. The NPI was enumerated on 2009-07-14 (~17 years ago), indicating an established presence in the market but a payer mix concentrated almost entirely in Medicaid.

Revenue is highly concentrated in a few molecular/genetic test codes: the top three Medicaid codes (81420, 81220, 81443) together account for 87.1% of the provider's Medicaid revenue. Individually those codes represent $82.8M (81420; 56.6% of Medicaid revenue), $35.3M (81220; 24.1%), and $9.5M (81443; 6.5%), which explains the bulk of the $146.7M lifetime Medicaid total.

The code mix and descriptions point to a specialty clinical molecular laboratory focused on prenatal and carrier genetic services: 81420 is a circulating cell-free fetal DNA panel used for fetal aneuploidy screening, 81220 is a CFTR carrier mutation panel, and 81443 is a multigene panel for conditions clustered in Ashkenazi Jewish populations. This profile is consistent with a women’s-health/reproductive-genetics service line that performs high-throughput sequencing and targeted carrier screening.

In-state competitive standing is strong for the highest-revenue tests: 81420 ranks #2 of 32 providers in-state at the 97th percentile and 81220 ranks #2 of 110 providers at the 99th percentile, signaling top-tier volume in prenatal noninvasive testing and CFTR carrier screening in California. These rank/percentile positions indicate the provider is a major statewide participant for those specific test markets rather than a marginal player.

Beyond the top two, the provider shows notably above-typical volume on several other specialized genetics tests. For example, 81329 ranks #3 of 56 providers (96th percentile; notably above typical state volume), and a set of tiered single-gene tests (81330, 81209, 81242, 81290) are listed as rank #1 of 6 providers (100th percentile; notably above typical state volume), which suggests leadership in a number of rare-disease or newborn/carrier testing niches.

Unit-paid amounts amplify revenue: average paid per claim is $277 for 81420, $206 for 81220, and $298 for 81443. Coupled with very large claim volumes, these per-claim rates explain why a relatively small set of codes drives a disproportionate share of the $146.7M Medicaid revenue.

Claim volumes for the top tests indicate substantial laboratory throughput: 81420 shows 298.8K claims, 81220 shows 171.3K claims, and 81443 shows 31.8K claims. These counts are consistent with a centralized, high-volume sequencing and genotyping operation that processes large numbers of prenatal and carrier screens.

From a payer oversight and contracting perspective, the business presents both concentration risk and negotiation clarity: absence of Medicare revenue means little diversification outside Medicaid, and 87.1% of Medicaid revenue coming from three codes (81420/81220/81443) creates a clear target set for utilization review or contract discussions. The provider’s high statewide ranks on core codes argue that any changes in coverage or pricing for those tests would materially affect network capacity for these services in California.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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,…	298,770	$280	$82.8M
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…	171,270	$210	$35.3M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	31,800	$300	$9.5M
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	157,830	$50	$7.4M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	30,020	$60	$1.8M
81422	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s) associated with conditions such as DiGeorge…	30,950	$50	$1.4M
81408	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code.	20,600	$70	$1.4M
81161	The lab analyst performs the technical lab test to analyze specific changes involving deleted, or possibly repeated, nucleotide sequences in the dystrophin gene, also known as the DMD gene.	37,430	$40	$1.3M
81243	The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal…	106,740	$10	$960.7K
81361	The lab analyst performs the technical lab test to detect the presence of specific changes in the hemoglobin, subunit beta (HBB) gene specifically for common variants, such as HbS, HbC, HbE.	35,240	$20	$704.9K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Myriad Women's Health, Inc. — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

37 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	30	300	$260	$18M
81408	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code.	3	10	380	$230	$10.8M
81162	The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called…	10	10	440	$500	$5.3M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	2	10	3,040	$290	$4.7M
81507	The lab analyst performs the technical lab tests to detect fetal trisomies 13, 18 and 21 in the maternal plasma during pregnancy. The analyst uses a micro assay technique and carries out an…	3	10	10,190	$280	$4.5M
81161	The lab analyst performs the technical lab test to analyze specific changes involving deleted, or possibly repeated, nucleotide sequences in the dystrophin gene, also known as the DMD gene.	2	10	3,090	$40	$3.5M
81361	The lab analyst performs the technical lab test to detect the presence of specific changes in the hemoglobin, subunit beta (HBB) gene specifically for common variants, such as HbS, HbC, HbE.	3	10	900	$30	$1.9M
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	110	190	$140	$1.6M
81422	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s) associated with conditions such as DiGeorge…	2	10	3,270	$60	$1.5M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	5	50	500	$160	$1.1M

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Quest Diagnostics Incorporated	NJ	Clinical Medical Laboratory	$111.2M	$637.7M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Veracyte, Inc.	CA	Clinical Medical Laboratory	$37.7M	$19.4M
Monogram Biosciences, Inc	CA	Clinical Medical Laboratory	$406.8K	$7.3M
Laguna Hills Pathology Lab LLC	CA	Clinical Medical Laboratory	$1M	$1.1M
Sebastian Sasu	CA	Anatomic Pathology & Clinical Pathology Physician	$180.2K	$0
Jenny Kuo	CA	Anatomic Pathology & Clinical Pathology Physician	$76K	$0

Myriad Women's Health, Inc. — Billing Profile & Reimbursement Data

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Myriad Women's Health, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

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Frequently Asked Questions

References