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NPI 1427133685 · Erie, PA · Clinical Medical Laboratory
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Associated Clinical Laboratories is a clinical medical laboratory provider located in Erie, Pennsylvania. This profile covers 349 Medicare and 292 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 | Associated Clinical Laboratories |
| Address | 1526 Peach St |
| City | Erie |
| State | PA |
| ZIP | 16501 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.9M |
| Medicare | $3.8M |
Payer mix and scale: This lab’s Medicaid business dwarfs its Medicare receipts — Medicare revenue: $3.8M while Medicaid revenue: $25.9M — indicating the entity is effectively Medicaid‑dominant and likely derives most of its operating scale from state contracts and high Medicaid patient volume. The large gap suggests strategic dependence on Medicaid reimbursement flows and market position within Pennsylvania.
Tenure and stability: The provider’s NPI was enumerated 2006-10-26 (~20 years ago), indicating a long-standing presence in the market that aligns with the high cumulative claims volumes reported across both payers. This tenure supports the idea of an established laboratory operation with mature collection and processing workflows.
Business/service-line implications — Medicare: The top Medicare revenue drivers are 36415, 80053, and 80061, which together account for 36.4% of this provider's total Medicare revenue. High volumes of 36415 (50.9K claims) alongside large counts for routine chemistry and lipid panels (80053: 30.2K claims; 80061: 20.7K claims) indicate a business built around high-throughput phlebotomy and routine diagnostic chemistry testing for ambulatory/physician‑office draws. This mix is characteristic of a reference laboratory or centralized draw-site network that processes large numbers of routine outpatient specimens.
Business/service-line implications — Medicaid: The top Medicaid revenue drivers are U0003, 80307, and 80050, which together account for 34.6% of this provider's total Medicaid revenue. The prominence of U0003 (44K claims, $3.2M revenue) and large volumes of presumptive drug testing (80307: 48K claims, $2M) and general health panels (80050: 27.4K claims, $1M) point to strong capacity for infectious disease molecular testing, public‑health screening (including COVID PCR), and high-volume toxicology screening for Medicaid populations.
Revenue concentration and top-code risk: For Medicare, the provider’s top three codes make up 36.4% of Medicare revenue, and for Medicaid its top three make up 34.6% — each payer shows meaningful revenue concentration in a small set of services. This concentration implies that payer policy or reimbursement changes to these specific codes (e.g., coverage, rate, or coding edits for U0003, 36415, or 80050) could materially affect overall revenue.
Competitive standing — national (Medicare): The provider ranks as a national high-volume actor on many routine lab codes: 36415 ranks #71 of 86467 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), 80053 ranks #97 of 26416 (100th percentile; notably above typical national volume), and multiple other common chemistry and hematology codes sit at the 99th–100th percentiles. These rankings characterize the provider as a major national processor for specimen collection and routine testing lines in Medicare data.
Competitive standing — state (Medicaid): In Pennsylvania Medicaid, the provider shows dominant in‑state volumes on strategic codes: U0003 ranks #7 of 197 (97th percentile; notably above typical state volume), 80050 ranks #4 of 172 (98th percentile; extreme outlier), and other high-impact codes such as 87491/87591 and 87631 also rank in the top state percentiles. This pattern signals a strong competitive position in-state for infectious disease testing, STD screening, and high-volume panels.
Specialty and higher-reimbursement services: Beyond routine tests, the provider reports sizable Medicaid revenue for molecular/genomic and definitive testing lines (examples include 81420 at $608.2K, 0241U at $604.8K, and 81220 at $313.2K), and Medicare shows substantive definitive drug testing revenue (G0480 $85.9K; G0481 $47.1K) and multiplex respiratory panels (87631 $48K). The presence of both high-throughput routine services and higher-reimbursement molecular/genomic assays suggests a diversified product mix that includes reference molecular diagnostics alongside mass screening operations.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
349 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 50,930 | $10 | $407.5K |
| 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. | 30,160 | $10 | $301.6K |
| 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. | 20,690 | $10 | $269K |
| 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… | 15,290 | $20 | $244.7K |
| 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… | 24,060 | $10 | $192.5K |
| 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… | 5,460 | $30 | $158.3K |
| 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… | 1,820 | $70 | $134.6K |
| 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).… | 12,900 | $10 | $129K |
| 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… | 770 | $110 | $85.9K |
| 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… | 10,480 | $10 | $83.9K |
Showing 1–10 of 349
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 349 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
349 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 4 | 10 | 30 | $2,950 | $2.2M |
| 87798 | 37 | 40 | 1,250 | $30 | $1.1M |
| 87799 | 6 | 10 | 790 | $40 | $128.8K |
| 87625 | 5 | 10 | 70 | $40 | $107.4K |
| 81279 | 5 | 10 | 110 | $180 | $98.5K |
| 81339 | 5 | 10 | 60 | $180 | $97K |
| 87529 | 12 | 10 | 80 | $30 | $96.6K |
| G0480 | 10 | 40 | 270 | $110 | $94.5K |
| 81513 | 5 | 10 | 490 | $140 | $86.1K |
| 87493 | 8 | 10 | 110 | $40 | $79.7K |
Showing 1–10 of 349
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.
292 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… | 44,010 | $70 | $3.2M |
| 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. | 47,960 | $40 | $2M |
| 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… | 27,440 | $40 | $1M |
| 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… | 16,790 | $60 | $956.7K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 41,690 | $20 | $875.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 40,900 | $20 | $858.9K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 6,290 | $120 | $779.6K |
| 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. | 85,870 | $10 | $772.9K |
| 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. | 72,870 | $10 | $728.7K |
| 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… | 47,500 | $20 | $712.4K |
Showing 1–10 of 292
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
292 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 11 | 20 | 710 | $80 | $1.7M |
| 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… | 15 | 130 | 310 | $60 | $769.3K |
| 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. | 9 | 210 | 730 | $40 | $689.7K |
| 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,… | 4 | 10 | 1,270 | $340 | $567.5K |
| 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… | 7 | 200 | 990 | $70 | $517.5K |
| 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… | 3 | 10 | 470 | $260 | $227K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 4 | 10 | 70 | $150 | $154.4K |
| 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… | 49 | 60 | 110 | $220 | $151.2K |
| 87800 | The lab analyst performs a test for multiple infectious organisms in one sample using direct nucleic acid probe technique. | 5 | 10 | 530 | $20 | $139.6K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 5 | 30 | 220 | $30 | $139.6K |
Showing 1–10 of 292
Other providers in the same ZIP code as Associated Clinical Laboratories, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Erie County Care Management | PA | Case Management Agency | $0 | $43.5M |
| New Directions Healthcare LLC | PA | Methadone Clinic | $83.3K | $14.2M |
| Community Health Net | PA | Federally Qualified Health Center (FQHC) | $0 | $7.2M |
| Erie County Care Management | PA | Case Management Agency | $0 | $5.5M |
| Luis Aparicio | PA | Endocrinology, Diabetes & Metabolism Physician | $44.2K | $644.9K |
| Nicholas Sala | PA | Ophthalmology Physician | $17.5K | $549.2K |
| Michelle Mioduszewski | PA | Occupational Therapist | $102.1K | $0 |
| Baron Denniston | PA | Psychiatry Physician | $25.6K | $0 |
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