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NPI 1396433231 · Torrance, CA · Clinical Medical Laboratory
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Pacific Medical Labs is a clinical medical laboratory provider located in Torrance, California. This profile covers 7 Medicare and 8 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 | Pacific Medical Labs |
| Address | 20695 S Western Ave Ste 104 |
| City | Torrance |
| State | CA |
| ZIP | 90501 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 28, 2023 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $7.3M |
| Medicaid | $16.1K |
Pacific Medical Labs is a high-volume clinical diagnostic lab focused on SARS-CoV-2 molecular testing and specimen collection: its Medicare top codes are U0003, 0240U, and U0005, with U0003 alone generating $3.2M (43.5% of this provider's total Medicare revenue) and G2023 appearing alongside as the specimen-collection code tied to the same testing line. The presence of multiplex respiratory codes such as 87502 and 87637 in the Medicare top-25 suggests the lab also performs broader respiratory pathogen testing, but these represent only a small fraction of Medicare revenue compared with COVID-19 testing codes.
Revenue concentration is extreme for both payers: the top 3 Medicare codes by revenue account for 85.5% of Medicare receipts, driven primarily by U0003 ($3.2M, 43.5%), 0240U ($2M, 27.3%), and U0005 ($1.1M, 14.7%). On Medicaid the top 3 codes account for 87.7% of Medicaid receipts, dominated by 0240U ($9.9K, 59.5%), U0003 ($3.1K, 18.8%), and G2023 ($1.6K, 9.4%).
Payer mix is heavily Medicare-weighted: lifetime Medicare revenue is $7.3M versus only $16.1K in Medicaid, indicating the provider operates effectively as a Medicare-focused laboratory with negligible Medicaid scale in absolute dollars. This scale disparity means analyses or network decisions should treat Medicare performance as the primary indicator of this lab’s business activity.
Several Medicare code volumes place the lab among national leaders: U0003 ranks #6 of 973 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code), U0005 ranks #6 of 1,090 providers nationally (100th percentile; extreme outlier), and 0240U ranks #4 of 184 providers nationally (98th percentile; notably above typical national volume). These rankings indicate a dominant national presence for high-throughput SARS-CoV-2 molecular testing.
By contrast, the provider’s Medicaid standing is more modest in-state: 0240U ranks #2 of 9 providers in-state (88th percentile), while U0003 and G2023 fall nearer the median statewide range (U0003 ranks #309 of 751, 59th percentile; G2023 ranks #172 of 497, 66th percentile). The lab’s Medicaid volumes and payments are small in absolute terms, which limits its competitive footprint in the California Medicaid market despite a high relative rank on 0240U.
Operational nuance is visible in turnaround-time coding: U0005 (a code tied to high-throughput testing completed within 2 calendar days) accounts for $1.1M (14.7% of Medicare revenue), suggesting the lab routinely offers expedited processing at scale for a substantial share of its Medicare testing volume. G2023 ($995.7K, 13.5% of Medicare revenue) being a top Medicare code further confirms specimen-collection services are a meaningful part of its workflow rather than pure send-out testing.
Data anomalies worth noting for payers and auditors: the provider reported 1.3K Medicaid claims for U0005 with a $0 avg paid/claim and $0 revenue, which contrasts with meaningful Medicare revenue for the same code. Any payment-policy review or contract negotiation should flag this payer-specific payment discrepancy for follow-up to confirm billing, payment adjudication, or reporting differences.
Tenure is short relative to legacy labs: the NPI was enumerated on 2023-04-28 (~3 years ago), yet the provider has quickly achieved national-scale volumes on several COVID-related CPT/HCPCS codes. This rapid growth to national outlier status on U0003 and U0005 suggests a focused, high-throughput operational model implemented soon after enumeration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 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… | 43,270 | $70 | $3.2M |
| 0240U | N/A | 14,370 | $140 | $2M |
| 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,… | 43,250 | $30 | $1.1M |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 43,290 | $20 | $995.7K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 370 | $90 | $35K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 200 | $140 | $28.1K |
| 87400 | The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B. | 370 | $10 | $5.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 0240U | N/A | 990 | $10 | $9.8K |
| 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… | 1,560 | $1 | $3.1K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1,560 | $1 | $1.6K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 150 | $10 | $1K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 100 | $10 | $520 |
| 87634 | The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique. | 60 | $10 | $300 |
| 87400 | The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B. | 90 | $1 | $180 |
| 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,… | 1,280 | $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
8 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… | 309 | 750 | 950 | $50 | $890K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 200 | 250 | 800 | $110 | $625.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 172 | 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,… | 192 | 520 | 470 | $10 | $116K |
| 0240U | N/A | 2 | 10 | 180 | $90 | $84.8K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 298 | 470 | 350 | $40 | $76.1K |
| 87634 | The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique. | 100 | 150 | 180 | $40 | $65.2K |
| 87400 | The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B. | 163 | 250 | 240 | $10 | $7.3K |
Other providers in the same ZIP code as Pacific Medical Labs, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Byram Healthcare Centers, Inc. | CA | Pharmacy | $0 | $271.4M |
| Myt Home Health Care, LLC | CA | Durable Medical Equipment & Medical Supplies | $0 | $44.9M |
| Usa Biosciences LLC | CA | Clinical Medical Laboratory | $2.6M | $18.5M |
| Biox Labs Inc | CA | Clinical Medical Laboratory | $10.6M | $15.1K |
| Imee Dhir | CA | Family Nurse Practitioner | $559K | $3.3K |
| Nicholas Fedor | CA | Physician Assistant | $12.4K | $0 |
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