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NPI 1396942926 · South Weymouth, MA · Clinical Medical Laboratory
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Harbor Medical Associates, Inc. is a clinical medical laboratory provider located in South Weymouth, Massachusetts. This profile covers 113 Medicare and 83 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 | Harbor Medical Associates, Inc. |
| Address | 541 Main St |
| City | South Weymouth |
| State | MA |
| ZIP | 02190 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 28, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $420.7K |
HARBOR MEDICAL ASSOCIATES, INC. is classified as a Clinical Medical Laboratory and its Medicare and Medicaid claims mix is dominated by routine diagnostic panels and chronic‑disease monitoring tests (lipid panels, CMP/BMP, CBC, TSH, A1C) alongside targeted assays such as vitamin D, natriuretic peptide, and parathyroid hormone. The presence of P9604 (travel allowance) and high claim counts on basic panels suggests the operation handles both outpatient draw volume and specimen collection for home‑bound or nursing‑home patients, supporting a broad diagnostic lab service line rather than a single narrow specialty.
Revenue concentration on Medicare is moderate but focused: the precomputed top 3 Medicare codes account for 31.4% of this provider's total Medicare revenue, led by 0241U ($170.1K, 11.1%), 80061 ($161.8K, 10.5%), and 80053 ($151.4K, 9.8%). This concentration indicates reliance on a small set of high‑revenue assays within a larger portfolio of routine tests, so changes in utilization or payer coverage for those specific assays could meaningfully affect Medicare revenue.
On Medicaid the top three codes similarly concentrate revenue: the precomputed top 3 Medicaid codes account for 31.7% of this provider's total Medicaid revenue, driven by 84443 ($43.1K, 11.8%), 82306 ($39.3K, 10.8%), and 85025 ($33.3K, 9.1%). These top Medicaid lines are the same types of routine endocrine, vitamin, and hematology tests seen on the Medicare side, showing consistent service offerings across payers but with materially smaller dollar volumes on Medicaid.
Payer mix is Medicare‑heavy: total Medicare revenue is $1.8M versus total Medicaid revenue of $420.7K, so Medicare represents the dominant revenue stream for this entity. Operational planning, contracting priorities, and capacity decisions should therefore prioritize Medicare reimbursement trends while monitoring Medicaid volumes as a secondary but still meaningful portion of business.
Competitive standing on Medicare is uneven: the provider is an extreme outlier for at least one code nationally—0241U ranks #4 of 2910 providers (100th percentile; described as an "extreme outlier, far above typical national volume for this code")—and shows additional extreme outlier or top‑percentile positioning on other Medicare codes (for example, 80048 ranks in the 100th percentile nationally). At the same time, many common panels such as 80061 and 80053 are high‑volume relative to peers but fall into the 99th percentile or similar, indicating both exceptional specialization on select assays and broadly high throughput on routine tests.
By contrast, the provider’s Medicaid competitive position is more regional/modest: top Medicaid codes generally rank in the middle‑to‑upper state percentiles (for example, 84443 is #54 of 186, 71st percentile; 85025 is #65 of 406, 84th percentile; 82306 is #52 of 161, 68th percentile). This pattern suggests HARBOR MEDICAL is a solid in‑state participant for standard Medicaid lab services but not a statewide dominant lab across the full array of assays.
Several specific codes are flagged as statistical outliers or unusually concentrated for this provider, which has operational implications. Most notably 0241U is called out as an "extreme outlier" and 80048 is also identified as an "extreme outlier, far above typical national volume for this code," indicating unusually high national volume for these assays; these outlier signals often reflect targeted testing capabilities, specialized contracts, or high referral volumes for those particular tests and merit follow‑up if payers or network managers are evaluating capacity or utilization risk.
The provider shows long tenure in the NPI file (NPI enumerated 2007-06-28 (~19 years ago)), which together with sustained claims across many common lab panels (CBC, BMP, CMP, lipid panel, TSH, A1C) points to an established diagnostic laboratory serving ongoing chronic‑care monitoring and routine testing needs in its market. That longevity supports operational stability but does not eliminate the importance of monitoring the few high‑revenue or outlier codes that disproportionately drive Medicare revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
113 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 0241U | N/A | 1,220 | $140 | $170.1K |
| 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. | 12,440 | $10 | $161.8K |
| 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. | 15,140 | $10 | $151.4K |
| 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… | 4,730 | $30 | $137.2K |
| 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… | 8,430 | $20 | $134.9K |
| 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… | 13,400 | $10 | $107.2K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 12,680 | $10 | $101.5K |
| 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).… | 7,660 | $10 | $76.6K |
| 83880 | The lab analyst measures the amount of natriuretic peptide, a hormone made by heart muscle cells, in the patient specimen. Blood levels of the hormone increase in patients with congestive heart… | 1,900 | $40 | $72.3K |
| 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. | 1,490 | $40 | $59.7K |
Showing 1–10 of 113
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 113 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
83 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 7,180 | $10 | $43.1K |
| 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… | 3,930 | $10 | $39.3K |
| 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… | 16,630 | $1 | $33.3K |
| ATP14 | N/A | 7,670 | $1 | $30.7K |
| 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… | 1,250 | $20 | $19.9K |
| 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 | $100 | $19.2K |
| 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).… | 6,240 | $1 | $18.7K |
| ATP17 | N/A | 3,760 | $1 | $15K |
| 82728 | The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute… | 2,610 | $10 | $13.1K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 2,440 | $10 | $12.2K |
Showing 1–10 of 83
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
83 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 266 | 370 | 500 | $40 | $605.1K |
| 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… | 31 | 30 | 1,140 | $60 | $598K |
| 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)… | 60 | 100 | 290 | $120 | $356.6K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 114 | 220 | 410 | $20 | $216.4K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 112 | 220 | 360 | $20 | $211.8K |
| 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… | 46 | 110 | 590 | $10 | $207.5K |
| 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… | 52 | 160 | 570 | $10 | $167.2K |
| 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… | 54 | 190 | 1,240 | $10 | $137.4K |
| 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. | 64 | 250 | 970 | $1 | $96K |
| 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… | 65 | 410 | 820 | $1 | $95.7K |
Showing 1–10 of 83
Other providers in the same ZIP code as Harbor Medical Associates, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| South Shore Hospital Inc. | MA | General Acute Care Hospital | $0 | $95.1M |
| Coastal Medical Associates | MA | Anesthesiology Physician | $0 | $10M |
| Jennifer Byer | MA | Medical Oncology Physician | $3.5M | $0 |
| Shields Imaging Of Eastern Massachusetts LLC | MA | Mobile Radiology Clinic/Center | $2.7M | $774.1K |
| New England Eye Surgical Center Inc | MA | Ophthalmologic Surgery Clinic/Center | $1.8M | $271.1K |
| Weymouth Endoscopy, LLC | MA | Endoscopy Clinic/Center | $844.3K | $4.7K |
| Patricia Hopkins | MA | Internal Medicine Physician | $733.6K | $0 |
| George Kroumpouzos | MA | Dermatology Physician | $721.7K | $0 |
| Stephen Koelbel | MA | Physical Medicine & Rehabilitation Physician | $392.9K | $0 |
| Rajinder Chawla | MA | Nephrology Physician | $367.9K | $11.8K |
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