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NPI 1427588029 · Owings Mills, MD · Clinical Medical Laboratory
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Diamond Medical Laboratories, LLC. is a clinical medical laboratory provider located in Owings Mills, Maryland. This profile covers 78 Medicare and 75 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 | Diamond Medical Laboratories, LLC. |
| Address | 66 Painters Mill Road |
| City | Owings Mills |
| State | MD |
| ZIP | 21117 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 15, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3M |
| Medicaid | $2.2M |
DIAMOND MEDICAL LABORATORIES, LLC. shows a clear clinical laboratory service line centered on high-volume routine testing and mobile specimen collection: its Medicare top codes are G0471, 85025, and 80053 (together accounting for 40.8% of Medicare revenue) and the line-up includes CBC (85025), CMP/BMP panels (80053, 80048) and many specimen-collection/travel allowances (G0471, P9603, P9604). The presence of large claim counts for venipuncture/collection (e.g., 54.1K claims for G0471 and 16.5K claims for 36415 on Medicare) plus very large P9603 volumes (215.8K claims) indicates the business operates substantial on-site or home/nursing-home specimen-collection operations rather than being limited to in-lab walk-ins.
Revenue concentration differs by payer: on Medicare the provider’s top three codes drive 40.8% of total Medicare revenue, showing a moderately concentrated Medicare mix around routine panels and collection services; on Medicaid the top three codes are even more dominant, accounting for 59.5% of total Medicaid revenue. For Medicaid the single largest revenue driver is U0004 (13.4K claims, $817.6K revenue), which alone contributes 37.9% of the provider’s Medicaid revenue and signals a heavy COVID-testing component to its Medicaid business.
The payer mix is mixed but Medicare is larger in scale: lifetime Medicare revenue is $3M versus Medicaid revenue of $2.2M, so Medicare is the single larger source of billed revenue while Medicaid remains a significant portion of the book and is heavily weighted to a few high-volume tests (U0004, 85025, 80053). This dual-payer footprint suggests the lab serves both Medicare-aged patients and Medicaid populations, with testing portfolio overlap across payers but different concentration drivers.
Competitive standing is uneven by code and payer: for Medicare the provider ranks highly on common lab panels—85025 is ranked #86 of 32833 providers nationally (100th percentile, described as notably above typical national volume) and 80048 is an extreme outlier nationally (#39 of 14725, 100th percentile, described as extreme outlier, far above typical national volume). At the same time G0471 is more typical in national context (#12 of 117, 91th percentile), indicating the provider is a major national-volume performer for some routine assays but only a typical participant for certain collection-specific codes.
In the state Medicaid market DIAMOND MEDICAL LABORATORIES posts top-tier ranks on several codes: U0004 is #4 of 32 in-state (90th percentile), 85025 is #4 of 229 in-state (99th percentile), and 80048 is #2 of 82 in-state (99th percentile and labeled an extreme outlier). These placements point to a strong in-state competitive position for high-volume testing (both routine panels and COVID testing), making the lab a leading Medicaid supplier in Maryland for several commonly billed tests.
Operational signal from ancillary codes: very large counts for P9603 (215.8K Medicare claims, $215.8K revenue) and substantial P9604 and 36415 volumes across payers indicate the provider is billing travel/prorated specimen-collection allowances at scale, consistent with a business model that includes outreach phlebotomy or nursing-home/homebound collection services. That pattern aligns with the prominence of G0471 on Medicare and the high Medicaid 36415 volume (65K claims, $130.1K revenue), reinforcing the mobile collection interpretation.
Tenure and presence: the NPI was enumerated on 2017-06-15 (~9 years ago), so the provider has an established multi-year Medicare/Medicaid billing history that includes pandemic-era COVID testing (e.g., U0004 activity) and sustained routine panel volumes. The combination of several years of activity and high percentile rankings on staple lab codes suggests operational stability and capacity to handle large specimen throughput.
Statistical outlier notes are code-specific and descriptive rather than diagnostic: 80048 is flagged as an "extreme outlier, far above typical national volume" on Medicare and also ranks extremely high in-state on Medicaid, while 85025 and 80053 show "notably above typical" or "typical" high-volume national placements depending on the code and payer. These labels indicate the provider is unusually large for some routine chemistry and collection services but more typical for other tests, and they should guide benchmarking and network contracting focus rather than being read as an operational judgment.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
78 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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) | 54,060 | $10 | $540.6K |
| 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… | 35,420 | $10 | $283.3K |
| 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. | 27,110 | $10 | $271.1K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 215,790 | $1 | $215.8K |
| 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… | 24,190 | $10 | $193.5K |
| 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… | 4,810 | $30 | $163.5K |
| 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… | 9,880 | $20 | $158K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 16,470 | $10 | $131.8K |
| 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… | 4,230 | $30 | $122.6K |
| 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. | 7,430 | $10 | $96.6K |
Showing 1–10 of 78
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 78 CPT/HCPCS codes.
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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.
75 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 13,400 | $60 | $817.6K |
| 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… | 48,530 | $10 | $242.7K |
| 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. | 37,250 | $10 | $223.5K |
| 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… | 32,850 | $10 | $164.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 65,030 | $1 | $130.1K |
| 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… | 9,160 | $10 | $128.2K |
| 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. | 13,920 | $10 | $83.5K |
| 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).… | 14,960 | $10 | $74.8K |
| 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… | 8,150 | $10 | $73.3K |
| 85027 | The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the… | 11,870 | $1 | $35.6K |
Showing 1–10 of 75
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
75 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… | 60 | 80 | 500 | $70 | $691.2K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 45 | 60 | 250 | $100 | $299.5K |
| 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… | 4 | 30 | 710 | $40 | $267.8K |
| 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 | 40 | 320 | $50 | $146.1K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 18 | 30 | 120 | $50 | $132.4K |
| 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… | 12 | 30 | 60 | $250 | $122.1K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 20 | 20 | 1,690 | $30 | $120.4K |
| 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. | 8 | 90 | 240 | $10 | $88.5K |
| 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… | 6 | 90 | 100 | $20 | $87.8K |
| 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… | 9 | 90 | 370 | $10 | $83.1K |
Showing 1–10 of 75
Other providers in the same ZIP code as Diamond Medical Laboratories, LLC., ranked by combined Medicare and Medicaid revenue.
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