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NPI 1366543795 · New Hyde Park, NY · Clinical Medical Laboratory
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Northwell Health Laboratories is a clinical medical laboratory provider located in New Hyde Park, New York. This profile covers 581 Medicare and 551 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 | Northwell Health Laboratories |
| Address | 450 Lakeville Rd Ste M50 |
| City | New Hyde Park |
| State | NY |
| ZIP | 11042 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $198.2M |
| Medicare | $48.5M |
NORTHWELL HEALTH LABORATORIES is a Clinical Medical Laboratory based in NEW HYDE PARK, NY with an NPI enumerated 2006-09-26 (~20 years ago), indicating long tenure in clinical laboratory services. The set of high-volume panel, anatomic pathology, and molecular codes on file is consistent with a large, centralized reference-lab operation rather than a small point-of-care lab.
Medicare revenue shows meaningful concentration: the precomputed top-3 Medicare codes account for 29.9% of this provider's total Medicare revenue. High-volume Medicare codes include 80053 ($3.4M, ranks #15 nationally, labeled an extreme outlier), P9604 ($3.4M, ranks #1 nationally, labeled an extreme outlier), and 84443 ($2.9M, ranks #17 nationally, labeled an extreme outlier), which together drive a sizable share of Medicare billings and reflect routine chemistry and TSH testing at scale.
Medicaid revenue is substantially larger in absolute terms: total Medicaid revenue is $198.2M versus Medicare revenue of $48.5M, indicating Medicaid is the dominant payer by dollars on file. The precomputed top-3 Medicaid codes account for 38.4% of Medicaid revenue, underscoring that a few high-volume test lines drive a large portion of Medicaid receipts.
The provider is a dominant statewide player for several Medicaid test lines and a national volume leader on select Medicare codes. Examples include Medicaid 87633 ($21.3M, ranks #1 in-state, labeled an extreme outlier) and 80053 ($5.9M, ranks #1 in-state, labeled an extreme outlier), while on the Medicare side P9604 ($3.4M) is ranked #1 nationally and many other Medicare codes are in the 99–100th percentiles, signaling major market share for specific tests.
Service-line mix indicates high-throughput infectious disease and molecular testing plus broad anatomic and clinical chemistry coverage. Medicaid top codes include 87633 ($21.3M) and multiple SARS-CoV-2 molecular codes U0004 ($18.1M), U0003 ($7.9M) and U0005 ($4.2M), while Medicare and Medicaid both show high volumes of panels and routine chemistry (80053, 80061) and hematology (85025), consistent with centralized specimen processing and multiplex/molecular workflows.
Operational footprint appears to include extensive specimen collection outside traditional clinic visits: Medicare lists P9604 (travel allowance) at $3.4M ranked #1 nationally and G0471 (SNF/home draws) at $1.2M ranked #5, which, together with very large claim counts for basic draws (36415), suggests a business model that includes home- and SNF-based specimen collection programs. This pattern supports a logistics-heavy operation with field collection and high specimen throughput.
Testing breadth extends into sexual health, genetic, and specialty testing on Medicaid: high Medicaid revenue for 87491 and 87591 (Chlamydia and Gonorrhea, each $5.1M, top in-state percentiles), 81220 (CFTR testing, $2.1M, ranks #2 in-state), and 88305 surgical pathology ($3.9M) show that the lab bills across STI screening, genetic panels, and anatomic pathology, not only routine chemistry. This diversified mix across molecular, serology, and pathology reduces reliance on any single test family even as a few codes remain revenue-concentrated.
Many individual codes are flagged as statistical outliers in national or state comparisons, with numerous Medicare and Medicaid codes labeled "extreme outlier" or "notably above typical"—for example, multiple Medicare codes appear in the 100th percentile and several Medicaid codes (87633, 80053, 82306) are 100th-percentile in-state. A small minority of high-revenue codes are described as "typical, unremarkable volume" (e.g., Medicaid U0003 labeled typical, unremarkable), highlighting that while the overall profile is dominated by outsized volumes, not every high-dollar COVID/molecular code is anomalous in-state.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
581 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 342,690 | $10 | $3.4M |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 210,400 | $20 | $3.4M |
| 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… | 181,740 | $20 | $2.9M |
| 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… | 90,930 | $30 | $2.6M |
| 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. | 199,210 | $10 | $2.6M |
| 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… | 304,320 | $10 | $2.4M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 225,010 | $10 | $1.8M |
| 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).… | 155,230 | $10 | $1.6M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 19,290 | $60 | $1.2M |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 123,370 | $10 | $1.2M |
Showing 1–10 of 581
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 581 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
581 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G0471 | 1 | 10 | 68,470 | $10 | $707.9K |
| P9604 | 1 | 10 | 1,880 | $20 | $306.6K |
| 87150 | 3 | 10 | 820 | $30 | $297.4K |
| 87798 | 8 | 40 | 740 | $30 | $218.3K |
| 88120 | 10 | 30 | 90 | $450 | $133.6K |
| U0004 | 1 | 20 | 450 | $70 | $114.7K |
| 87507 | 3 | 10 | 120 | $410 | $83.7K |
| G0483 | 2 | 20 | 270 | $240 | $82.4K |
| G0480 | 6 | 30 | 170 | $110 | $76.5K |
| 87801 | 4 | 20 | 60 | $70 | $75.1K |
Showing 1–10 of 581
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.
551 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 85,520 | $250 | $21.3M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 245,260 | $70 | $18.1M |
| 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… | 105,410 | $80 | $7.9M |
| 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. | 659,160 | $10 | $5.9M |
| 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… | 246,560 | $20 | $5.9M |
| 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… | 119,600 | $40 | $5.3M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 182,180 | $30 | $5.1M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 181,990 | $30 | $5.1M |
| 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. | 430,120 | $10 | $4.3M |
| 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,… | 200,190 | $20 | $4.2M |
Showing 1–10 of 551
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
551 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 14 | 340 | 1,090 | $70 | $1.4M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 3 | 100 | 1,490 | $70 | $1.3M |
| 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… | 27 | 40 | 440 | $90 | $511.9K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 1 | 140 | 360 | $130 | $492.1K |
| 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,… | 9 | 300 | 1,710 | $20 | $458.6K |
| 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… | 9 | 110 | 690 | $50 | $442K |
| 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. | 20 | 290 | 1,900 | $30 | $390.6K |
| 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… | 15 | 30 | 550 | $100 | $359.8K |
| 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 | 60 | 230 | $370 | $340.9K |
| 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 | 260 | $480 | $329.6K |
Showing 1–10 of 551
Other providers in the same ZIP code as Northwell Health Laboratories, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Freedom Care LLC | NY | Home Health Agency | $0 | $3B |
| Optum Medical Care Of New Jersey PC | NY | Pediatrics Physician | $0 | $219.4M |
| North Shore University Hospital | NY | Case Management Agency | $0 | $166.6M |
| Prohealth Care Associates LLP | NY | Internal Medicine Physician | $0 | $69.4M |
| Personal Touch Home Care Of New York, Inc. | NY | Early Intervention Provider Agency | $0 | $19.3M |
| Nhpe, LLC | NY | Ambulatory Surgical Clinic/Center | $831.7K | $3M |
| Stuart Weinerman | NY | Endocrinology, Diabetes & Metabolism Physician | $2.3M | $2.3K |
| Jason Karp | NY | Pulmonary Disease Physician | $2.1M | $35.2K |
| Vishesh Agrawal | NY | Radiation Oncology Physician | $2.1M | $13K |
| Richard Furie | NY | Rheumatology Physician | $2.1M | $19.5K |
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