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NPI 1407487465 · Pelham, AL · Clinical Medical Laboratory
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Golden Point Solutions LLC is a clinical medical laboratory provider located in Pelham, Alabama. This profile covers 42 Medicare and 90 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 | Golden Point Solutions LLC |
| Address | 153 Cahaba Valley Pkwy |
| City | Pelham |
| State | AL |
| ZIP | 35124 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 29, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $16.4M |
| Medicare | $146.9K |
This NPI is effectively a Medicaid-first clinical laboratory: lifetime Medicaid revenue is $16.4M versus total Medicare revenue of $146.9K, indicating the business is overwhelmingly dependent on Medicaid volumes rather than Medicare receipts. The scale difference suggests payer mix and contract strategy oriented toward state programs and high-volume public testing rather than fee-for-service Medicare business lines.
Medicare revenue is concentrated in a small number of molecular and targeted tests: the top 3 Medicare codes account for 50.7% of Medicare revenue, led by 87500 ($35.5K, 26.4% of Medicare revenue) and 0241U ($25.9K, 19.3%). The presence of U0004 ($6.5K, 4.9%) among the top three confirms that COVID high-throughput testing is a meaningful but smaller component of the provider’s Medicare mix.
Medicaid revenue is highly concentrated in nucleic-acid/molecular infectious disease testing: the top 3 Medicaid codes account for 60.5% of Medicaid revenue, driven by 87798 ($5.4M, 34.3%) and 87633 ($3.5M, 22.0%), with U0004 ($668.2K, 4.2%) also in the top three. This concentration indicates the lab’s core service offering is amplified probe/NAAT-style molecular diagnostics and respiratory multiplex testing at scale for state patients.
The overall code mix signals a lab operation built around high-throughput molecular infectious disease testing plus substantial drug-testing capability. Medicaid detail shows very large claim counts for molecular codes (e.g., 21.9K claims for 87798 and 19.8K claims for 87633) alongside meaningful revenue for definitive drug testing codes such as G0480 ($495.8K) and presumptive screens like 80307 ($548.4K), implying integrated testing services for public health and substance-use monitoring.
Competitive standing on Medicare is mixed: for select tests the provider ranks high nationally (for example 87500 ranks #78 of 838 providers nationally at the 91th percentile, and 0241U ranks #46 of 2910 at the 98th percentile), but overall Medicare dollars are small ($146.9K) so those high-code percentiles reflect niche strength on specific tests rather than large Medicare market share. Several other Medicare codes show typical, unremarkable national volumes which aligns with the provider being a significant performer for select assays but modest in total Medicare revenue.
In-state competitive standing for Medicaid shows material scale in molecular respiratory and infectious testing: 87633 ranks #6 of 98 providers in-state at the 95th percentile and 87798 ranks #9 of 57 at the 86th percentile, reflecting a strong state-level footprint for these test families. Notably 87500 is an in-state outlier, ranking #1 of 15 providers (100th percentile; notably above typical state volume), which highlights exceptional dominance for vancomycin-resistance testing locally.
Operational and revenue concentration risk is visible: with the top 3 Medicaid codes representing 60.5% of Medicaid revenue and the top 3 Medicare codes representing 50.7% of Medicare revenue, the provider’s financial performance is highly sensitive to demand or reimbursement changes for a narrow group of molecular and drug-testing codes. Payer-specific dependence (Medicaid-heavy) amplifies that sensitivity to state reimbursement policy and public health testing demand.
The entity has been enumerated since 2020-01-29 (~6 years ago), which places its establishment during the COVID era and aligns with the prominence of SARS-CoV-2 testing codes (U0004, U0002, U0005 and related amplified-probe codes) in both Medicare and Medicaid billing. This timing supports the interpretation that the lab’s service lines and capacity were either initiated or scaled up in response to pandemic-era testing needs.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
42 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 1,040 | $30 | $35.5K |
| 0241U | N/A | 190 | $140 | $25.9K |
| 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… | 90 | $70 | $6.5K |
| 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. | 570 | $10 | $5.7K |
| 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. | 420 | $10 | $5.4K |
| 87186 | The lab analyst performs the technical steps to evaluate a culture isolate’s susceptibility, or sensitivity, to multiple antimicrobial agents, commonly called antibiotics, by observing growth of the… | 620 | $10 | $5K |
| 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… | 40 | $110 | $4.9K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 110 | $30 | $3.8K |
| 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… | 230 | $20 | $3.7K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 100 | $30 | $3.5K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 42 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
42 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| U0004 | 6 | 10 | 460 | $70 | $117.5K |
| G0480 | 24 | 30 | 90 | $110 | $52.5K |
| U0005 | 13 | 20 | 100 | $20 | $21.9K |
| 80307 | 88 | 120 | 170 | $60 | $19.7K |
| 87077 | 11 | 30 | 30 | $10 | $17K |
| 82306 | 223 | 340 | 60 | $30 | $16K |
| 86376 | 4 | 10 | 130 | $10 | $13.7K |
| 87086 | 38 | 80 | 60 | $10 | $13.2K |
| 80053 | 105 | 670 | 140 | $10 | $13.1K |
| 84443 | 127 | 560 | 90 | $20 | $12.2K |
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Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
90 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 21,890 | $250 | $5.4M |
| 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… | 19,750 | $180 | $3.5M |
| 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… | 13,100 | $50 | $668.2K |
| 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. | 11,430 | $50 | $548.4K |
| 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… | 10,120 | $50 | $495.8K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 21,870 | $20 | $481.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 5,100 | $90 | $469.5K |
| 87541 | The lab analyst performs a test for the bacteria Legionella pneumophila using amplified nucleic acid probe technique. L. pneumophila can inhabit facility water and air conditioning systems and may… | 18,110 | $20 | $416.5K |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 18,110 | $20 | $416.5K |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 18,110 | $20 | $416.5K |
Showing 1–10 of 90
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
90 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 9 | 60 | 1,260 | $60 | $1.2M |
| 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… | 6 | 100 | 470 | $130 | $1.2M |
| 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 | 70 | 380 | $60 | $893.8K |
| 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… | 5 | 20 | 10,040 | $40 | $825.9K |
| 87507 | The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal… | 4 | 10 | 1,020 | $110 | $784.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 10 | 40 | 450 | $20 | $591.3K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 8 | 40 | 460 | $20 | $584.1K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 14 | 40 | 1,540 | $10 | $397.4K |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 8 | 40 | 1,440 | $20 | $372.1K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 32 | 90 | 500 | $40 | $303.6K |
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Other providers in the same ZIP code as Golden Point Solutions LLC, ranked by combined Medicare and Medicaid revenue.
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