Loading...
NPI 1487212551 · Greensboro, NC · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Greensboro, North Carolina. This profile covers 290 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 | Quest Diagnostics Clinical Laboratories Inc |
| Address | 4380 Federal Dr Ste 100 |
| City | Greensboro |
| State | NC |
| ZIP | 27410 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 3, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $22M |
| Medicare | $14.6M |
Payer mix and scale: QUEST DIAGNOSTICS CLINICAL LABORATORIES INC reports $14.6M in total Medicare revenue and $22M in total Medicaid revenue, so Medicaid represents the larger single-payer revenue stream for this NPI rather than Medicare. The presence of substantial revenue from both payers indicates a mixed-payer operating footprint rather than a single‑payer dependency.
Top-code revenue concentration (Medicare): the top three Medicare codes (80053, 82306, 84443) account for 34.4% of this provider's total Medicare revenue, indicating meaningful concentration in a small group of routine chemistry and endocrine assays. Those individual codes are large line items (80053 $1.3M; 82306 $1.3M; 84443 $1.2M) and together drive a substantial share of Medicare receipts.
Top-code revenue concentration (Medicaid): the top three Medicaid codes (80061, 82306, 87491) account for 25.1% of this provider's total Medicaid revenue, showing a similar but lower concentration on a mix of lipid panels, vitamin D measurement, and STI NAAT testing. Each of the named Medicaid codes contributes roughly $1.2M–$1.3M in revenue (80061 $1.3M; 82306 $1.2M; 87491 $1.2M), highlighting panels and infectious-disease assays as key Medicaid drivers.
Operational profile and service lines: the CPT mix (high-volume routine chemistry panels such as 80053 133K claims and 80061 90.5K claims, frequent phlebotomy 36415 124.8K claims, and large CBC 85025 102.6K claims) is consistent with a centralized, high-throughput clinical laboratory that processes very large specimen volumes for routine ambulatory chemistry, hematology, and collection services. The concurrent high volumes of STI NAATs (87491/87591), molecular SARS‑CoV‑2 testing (U0003 10.4K claims, $645.5K Medicaid revenue), and definitive drug testing (G0480 $603.7K Medicaid revenue) indicate capabilities in molecular and specialized testing beyond basic panels.
Competitive standing — Medicare (national): this NPI ranks at the extreme high end nationally on many core assays, with multiple codes listed as 100th percentile / "extreme outlier" (for example 80053 ranks #35 of 26416 nationally and 82306 ranks #29 of 12453), which signals national-scale volume for routine chemistry and endocrine tests relative to peers. Those percentile/rank labels indicate the NPI is a national volume leader for numerous common lab codes rather than a modest local participant.
Competitive standing — Medicaid (state): within North Carolina the provider is a high-volume competitor for standard panels and infectious-disease testing, with codes like 80061 at #4 of 325 in-state (99th percentile), 82306 at #5 of 162 (98th percentile), and 80053 at #5 of 289 (99th percentile). These ranks show the provider is among the leading in-state performers for Medicaid-reimbursed lab services, especially for lipid panels, vitamin D, and CMPs.
Breadth and clinical depth: beyond high-volume routine testing, the billing mix includes notable volumes for immunology/infectious assays and pathology/microbiology (examples include 86480 TB interferon testing $541.9K Medicare revenue ranked #7 of 475 nationally; 88305 surgical pathology $271.1K Medicare revenue ranked #221 of 14580), demonstrating that the lab operates a diversified service line that includes immunologic assays, culture/susceptibility work, and pathology interpretation. This breadth supports both primary-care laboratory routing and more specialized clinical workflows.
Tenure and scale-up: the NPI was enumerated on 2019-06-03 (~7 years ago) and has reached large billing volumes across both Medicare and Medicaid in a relatively short enrollment window. The combination of recent enumeration and exceptionally high claim counts and ranks suggests rapid operational scale-up to a centralized, high-throughput laboratory model rather than a small independent office-based lab.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
290 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. | 133,010 | $10 | $1.3M |
| 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… | 45,710 | $30 | $1.3M |
| 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… | 77,230 | $20 | $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. | 90,510 | $10 | $1.2M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 124,770 | $10 | $998.2K |
| 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… | 102,630 | $10 | $821K |
| 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).… | 57,410 | $10 | $574.1K |
| 86480 | The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies. | 8,880 | $60 | $541.9K |
| 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. | 9,850 | $40 | $394K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 20,220 | $20 | $303.2K |
Showing 1–10 of 290
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 290 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
290 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87999 | 2 | 10 | 5,330 | $240 | $1.3M |
| U0003 | 13 | 10 | 90 | $70 | $463.6K |
| 83704 | 3 | 10 | 290 | $30 | $379.7K |
| 86037 | 2 | 10 | 17,780 | $10 | $209.8K |
| U0005 | 15 | 20 | 310 | $20 | $158.1K |
| G0472 | 2 | 10 | 40 | $50 | $153.4K |
| 83521 | 7 | 10 | 100 | $20 | $152.9K |
| 83013 | 2 | 10 | 840 | $70 | $115.9K |
| 82542 | 5 | 10 | 230 | $20 | $93.9K |
| 87522 | 4 | 10 | 80 | $40 | $91.6K |
Showing 1–10 of 290
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 |
|---|---|---|---|---|
| 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. | 131,580 | $10 | $1.3M |
| 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… | 57,980 | $20 | $1.2M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 49,790 | $20 | $1.2M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 49,620 | $20 | $1.2M |
| 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. | 146,040 | $10 | $1M |
| 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… | 70,680 | $10 | $777.4K |
| 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. | 18,960 | $40 | $720.4K |
| 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).… | 93,990 | $10 | $657.9K |
| 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… | 107,740 | $10 | $646.4K |
| 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… | 10,410 | $60 | $645.5K |
Showing 1–10 of 292
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
292 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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,… | 7 | 20 | 240 | $400 | $13.6M |
| 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… | 11 | 30 | 170 | $260 | $2.6M |
| 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… | 20 | 160 | 840 | $70 | $2.3M |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 6 | 10 | 1,360 | $150 | $1.8M |
| G0483 | 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… | 82 | 110 | 1,450 | $110 | $1.7M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 9 | 40 | 480 | $40 | $1.4M |
| 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… | 69 | 80 | 420 | $30 | $1.2M |
| G0482 | 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… | 51 | 60 | 1,640 | $100 | $940.2K |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 5 | 40 | 220 | $60 | $920.5K |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 7 | 10 | 2,000 | $40 | $905.6K |
Showing 1–10 of 292
Other providers in the same ZIP code as Quest Diagnostics Clinical Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Lindley Habilitation Services Inc | NC | Community/Behavioral Health Agency | $0 | $187.9M |
| Health & Home Services, Inc. | NC | Nursing Care Agency | $0 | $23.9M |
| Exceptional Family Support, LLC | NC | Community/Behavioral Health Agency | $0 | $14.4M |
| Solstas Lab Partners Group LLC | NC | Clinical Medical Laboratory | $0 | $11.7M |
| Angela Hawkes | NC | Rheumatology Physician | $2.3M | $0 |
| James Beekman | NC | Rheumatology Physician | $2.1M | $0 |
| Asap Labs And Care, LLC | NC | Clinical Medical Laboratory | $78.4K | $1.7M |
| Greensboro Ophthalmology Asc LLC | NC | Ambulatory Surgical Clinic/Center | $750.1K | $379.4K |
| Paula Pecen | NC | Ophthalmology Physician | $1.1M | $0 |
| Mario Mitkov | NC | Dermatology Physician | $881.9K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.