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NPI 1437596855 · Fairfax, VA · Clinical Medical Laboratory
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Inova Health Care Services is a clinical medical laboratory provider located in Fairfax, Virginia. This profile covers 335 Medicare and 189 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 | Inova Health Care Services |
| Address | 2832 Juniper St |
| City | Fairfax |
| State | VA |
| ZIP | 22031 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 24, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.8M |
| Medicare | $5.4M |
INOVA HEALTH CARE SERVICES is operating as a high-volume clinical diagnostic laboratory: its Medicare top codes are dominated by routine chemistry and hematology testing (80053, 80061, 84443, 36415, 85025) and diagnostic panels such as CMP and lipid panels, indicating core lab services and high-throughput specimen collection and processing rather than specialized procedural care. The presence of both high claim counts (e.g., 57.2K claims for 80053, 70.1K for 36415) and mid-range per-claim payments suggests a service-line focused on scale and volume.
Revenue concentration is meaningful on both payers: precomputed figures show the top 3 Medicare codes account for 36.9% of Medicare revenue and the top 3 Medicaid codes account for 36.3% of Medicaid revenue, indicating that a relatively small set of routine lab panels and tests drives more than one-third of this provider’s revenue in each program. This concentration heightens the commercial importance of maintaining capacity and payer relationships for those specific codes.
Payer mix shows this lab serves both programs at comparable scale but with slightly larger Medicaid lifetime revenue: Total Medicare revenue is $5.4M while Total Medicaid revenue is $6.8M, so Medicaid represents the larger revenue source in lifetime dollars. This suggests the provider’s operational footprint includes substantial participation in state-level public health and outpatient testing demand alongside Medicare services.
INOVA is a strong national performer on many Medicare codes: multiple high-volume Medicare codes rank at or near the 100th percentile nationally (for example, 80053 ranks #63 of 26416, 80061 ranks #58 of 21671, 83036 ranks #71 of 44997), with several labeled as “extreme outlier” or “notably above typical national volume.” These rankings indicate INOVA functions as a major national-scale producer for common lab tests in Medicare populations.
State-level competitive standing on Medicaid is also prominent for several codes: for Medicaid U0003 ranks #10 of 111 in-state (92nd percentile) and 80061 ranks #5 of 224 in-state (98th percentile) while 80050 ranks #2 of 66 in-state (98th percentile). Several Medicaid codes are described as “extreme outlier” or “notably above typical state volume,” which supports the conclusion that INOVA is a leading lab within Virginia for routine panels and COVID-19 testing volumes.
Specific code-level patterns point to operational priorities and public health responsiveness: high Medicaid volume for U0003 (18.2K claims, $1.2M revenue) and U0005 (11.7K claims, $211K revenue) demonstrates substantial COVID-19 PCR testing activity on the Medicaid side, while Medicare volumes for molecular and infectious codes (e.g., U0003, 87635) are smaller but present, indicating cross-payer infectious-disease testing capacity.
The provider shows repeated high-volume specimen collection activity across payers, reinforcing a centralized phlebotomy and specimen-processing model: 36415 appears at extremely high claim counts on both Medicare (70.1K claims, $420.6K revenue; 100th percentile) and Medicaid (91.3K claims, $91.3K revenue; 99th percentile), consistent with large-scale outpatient draw stations or integrated hospital lab services that capture many routine collections.
Tenure is long-standing: NPI enumeration occurred on 2013-05-24 (~13 years ago), indicating over a decade of billing history under this NPI which supports the observed high cumulative revenues and scale in both Medicare and Medicaid programs.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
335 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 57,210 | $10 | $572.1K |
| 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. | 36,880 | $10 | $479.5K |
| 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… | 26,490 | $20 | $423.8K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 70,110 | $10 | $420.6K |
| 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… | 42,630 | $10 | $341K |
| 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… | 10,450 | $30 | $303.1K |
| 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).… | 23,140 | $10 | $208.3K |
| 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… | 16,230 | $10 | $129.8K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 6,790 | $20 | $122.1K |
| 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. | 2,860 | $40 | $114.2K |
Showing 1–10 of 335
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 335 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.
189 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… | 18,150 | $60 | $1.2M |
| 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. | 44,280 | $10 | $398.6K |
| 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. | 48,040 | $10 | $336.3K |
| 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… | 17,490 | $20 | $314.8K |
| 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… | 18,630 | $20 | $298.1K |
| 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… | 23,580 | $10 | $235.8K |
| 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).… | 37,750 | $10 | $226.5K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 7,570 | $30 | $219.5K |
| 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,… | 11,720 | $20 | $211K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 7,560 | $20 | $181.4K |
Showing 1–10 of 189
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
189 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87512 | The lab analyst performs a test to quantify infection with Gardnerella vaginalis using nucleic acid probe technique. Gardnerella vaginalis, typically causes bacterial vaginosis, an infection of the… | 2 | 10 | 930 | $20 | $753.9K |
| 87799 | The lab analyst performs a test to quantify infection with an infectious agent, not otherwise specified in another code, using a nucleic acid probe technique. Use this code if you know the laboratory… | 4 | 10 | 1,000 | $30 | $502.2K |
| 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. | 138 | 170 | 3,790 | $40 | $415.2K |
| 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… | 10 | 110 | 1,150 | $40 | $331.1K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 12 | 20 | 350 | $30 | $170.5K |
| 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… | 137 | 160 | 1,900 | $30 | $129.8K |
| 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. | 27 | 230 | 5,240 | $1 | $93.2K |
| 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 | 2 | 10 | 7,870 | $1 | $89K |
| 81514 | The lab analyst performs the technical lab tests on a vaginal fluid specimen for quantitative real–time amplification of DNA markers for six bacterial species listed in the code descriptor, and… | 1 | 10 | 710 | $100 | $74.5K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 50 | 230 | 300 | $40 | $65.4K |
Showing 1–10 of 189
Other providers in the same ZIP code as Inova Health Care Services, ranked by combined Medicare and Medicaid revenue.
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