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NPI 1437252806 · New Britain, CT · Clinical Medical Laboratory
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Starling Physicians, PLLC is a clinical medical laboratory provider located in New Britain, Connecticut. This profile covers 75 Medicare and 78 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 | Starling Physicians, PLLC |
| Address | 1 Lake St |
| City | New Britain |
| State | CT |
| ZIP | 06052 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.4M |
| Medicare | $809.9K |
STARLING PHYSICIANS, PLLC is operating as a clinical medical laboratory with a heavy mix of specimen collection and routine chemistry/hematology testing: its Medicare top codes are dominated by venipuncture and common panels such as 36415 (12.7K claims, $101.8K revenue), 80053 (8.5K claims, $85.1K revenue), and 85025 (9.7K claims, $77.5K revenue), and Medicaid billing similarly emphasizes high-volume panels and infectious disease testing (e.g., 87491 and 87591). The overall CPT mix — frequent use of CMP, CBC, lipid panels, TSH and vitamin D — indicates a core outpatient diagnostic laboratory model that processes large numbers of routine blood specimens.
Payer mix is heavily weighted toward Medicaid: the provider reports $809.9K in total Medicare revenue versus $4.4M in total Medicaid revenue, making Medicaid the larger source of billed dollars for this entity. This is not a single-payer operation, but Medicaid clearly accounts for the majority of lifecycle billing activity in absolute dollars.
Revenue concentration on Medicare is moderate: the precomputed top-3 Medicare codes account for 36.5% of this provider's total Medicare revenue. Those top three Medicare contributors are 36415 ($101.8K, 14.0%), 80053 ($85.1K, 11.7%), and 85025 ($77.5K, 10.7%), showing that routine venipuncture and common chemistry/hematology panels drive a large share of Medicare receipts.
Medicaid revenue is similarly concentrated: the precomputed top-3 Medicaid codes make up 33.8% of this provider's total Medicaid revenue. The largest Medicaid line items are 87491 ($474.2K, 12.1%), 87591 ($471.4K, 12.0%), and 80050 ($379.8K, 9.7%), which together indicate a major focus on sexually transmitted infection NAAT testing and general health panel screening in the Medicaid population.
Competitive standing differs by payer and code: on Medicare the practice posts top-percentile national volumes for many routine codes (for example 36415 ranks #173 of 86467, 100th percentile; 80053 ranks #234 of 26416, 99th percentile; 85025 ranks #208 of 32833, 99th percentile), indicating it is a high-volume national participant for specimen collection and common assays. In contrast, Medicaid rankings are state-focused and show an especially strong position on some lines — most notably 80050 is an "extreme outlier, far above typical state volume" and ranks #1 of 16 providers in-state — while STI NAAT codes 87491 and 87591 rank #10 of 49 in-state (81st percentile) consistent with a meaningful in-state share for those tests.
There are notable specialized and molecular testing lines alongside routine panels: bacterial vaginosis algorithmic testing 81513 generates $305K (7.8% of Medicaid revenue) and ranks #4 of 12 in-state, while multiplex respiratory testing 87636 appears on both payers (Medicaid: $155.3K, 4.0% of Medicaid revenue, ranks #11 of 28 in-state; Medicare: $8.3K, 1.1% of Medicare revenue, ranks #431 of 2192 nationally). These figures suggest the lab supports both high-volume screening and selective molecular diagnostics.
The provider has long tenure in the system, with its NPI enumerated 2006-09-07 (~20 years ago), which aligns with established operational capacity needed to sustain the multi-thousand claim volumes reported across both payers. Longevity plus the observed code mix supports a sustained outpatient laboratory service-line rather than a recently formed or transient operation.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
75 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. | 12,720 | $10 | $101.8K |
| 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. | 8,510 | $10 | $85.1K |
| 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… | 9,680 | $10 | $77.5K |
| 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. | 5,340 | $10 | $69.5K |
| 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… | 4,200 | $20 | $67.1K |
| 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… | 1,700 | $30 | $49.2K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,540 | $30 | $46.1K |
| 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).… | 3,380 | $10 | $33.8K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 1,550 | $20 | $23.2K |
| 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. | 520 | $40 | $20.7K |
Showing 1–10 of 75
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 75 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.
78 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 16,940 | $30 | $474.2K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 16,840 | $30 | $471.4K |
| 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… | 13,100 | $30 | $379.8K |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 2,960 | $100 | $305K |
| 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. | 28,210 | $10 | $253.9K |
| 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… | 12,670 | $20 | $253.4K |
| 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… | 37,500 | $10 | $187.5K |
| 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. | 26,960 | $10 | $161.7K |
| 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… | 1,160 | $130 | $155.3K |
| 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… | 14,270 | $10 | $142.7K |
Showing 1–10 of 78
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
78 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… | 32 | 50 | 3,340 | $60 | $1M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 45 | 90 | 3,980 | $40 | $424.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 10 | 50 | 4,240 | $30 | $410.4K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 10 | 50 | 4,240 | $30 | $409.9K |
| 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… | 11 | 30 | 730 | $110 | $343.7K |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 4 | 10 | 1,800 | $80 | $325.9K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 8 | 20 | 1,770 | $30 | $278.8K |
| 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,… | 35 | 50 | 4,960 | $20 | $273.9K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 8 | 30 | 3,460 | $30 | $219.9K |
| 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… | 16 | 30 | 4,170 | $10 | $142.7K |
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Other providers in the same ZIP code as Starling Physicians, PLLC, ranked by combined Medicare and Medicaid revenue.
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