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NPI 1518366426 · Monmouth, NJ · Clinical Medical Laboratory
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Cliffside Labs L.L.C. is a clinical medical laboratory provider located in Monmouth, New Jersey. This profile covers 88 Medicare and 37 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 | Cliffside Labs L.L.C. |
| Address | 7 Deer Park Drive, Ste K |
| City | Monmouth |
| State | NJ |
| ZIP | 08852 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 15, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $22.4M |
| Medicaid | $324.8K |
CLIFFSIDE LABS L.L.C. is heavily Medicare‑weighted in scale: lifetime Medicare revenue is $22.4M compared with $324.8K in Medicaid, indicating Medicare is the primary payer driving the business. The provider’s NPI was enumerated 2014-08-15 (~12 years ago), so this is an established operation with a long enough tenure to build national referral relationships.
The provider’s Medicare code mix is dominated by high‑complexity molecular and hereditary sequencing assays — examples include 81317, 81307, and 81298 (PMS2, PALB2, MSH6 sequencing respectively) — which identifies the operation as a clinical molecular laboratory focused on comprehensive genetic sequencing and oncology/hereditary risk tests. Many of the top Medicare CPT/HCPCS entries are full gene sequencing or multigene analyses, indicating an emphasis on specialized, higher‑complexity testing rather than routine anatomic or chemistry panels.
Revenue concentration on Medicare is material but not extreme: the precomputed top three Medicare codes account for 28.8% of Medicare revenue, with those top codes being 81317, 81307, and 81298. Each of those three codes shows high national placement (81317 ranks #2 of 51, 98th percentile; 81307 ranks #4 of 62, 95th percentile; 81298 ranks #2 of 50, 98th percentile) and is described as "notably above typical national volume," underscoring that a relatively small set of sequencing tests contribute a large share of Medicare revenue.
Across Medicare sequencing lines CLIFFSIDE posts multiple high national ranks and top percentiles, signaling a strong competitive standing for specific assays: several codes rank in the top five nationally (for example, 81185 #3 of 25, 92th percentile; 81249 #5 of 62, 93th percentile; 81238 #5 of 54, 92th percentile). A cluster of codes are ranked #1 with 100th percentile designations (for example 81274, 81181, 81183, 81343, 81178) and others sit in the 90s percentiles, which together indicate the provider acts as a national high‑volume specialist for many targeted genetic tests even if total Medicare revenue is concentrated in a few signature assays.
Medicaid activity is small in absolute terms ($324.8K lifetime) and heavily concentrated in drug‑testing panels: the top three Medicaid codes (80307, G0483, G0480) together account for 68.7% of Medicaid revenue and are primarily definitive or presumptive drug testing services. In‑state rankings for those Medicaid drivers are modest to below‑median (80307 ranks #90 of 151, 41th percentile; G0483 ranks #21 of 32, 35th percentile; G0480 ranks #77 of 110, 30th percentile), indicating the provider is a modest state participant in Medicaid drug‑testing volumes despite those lines representing most of its Medicaid dollars.
The payer‑specific service mix suggests distinct product lines by payer: on Medicare the practice centers on high‑complexity sequencing and oncology/hereditary panels, while Medicaid receipts are largely from drug‑testing services (definitive and presumptive panels). This divergence implies the organization operates both high‑complexity molecular workflows that attract Medicare referrals and separate contractable drug‑testing capacity that captures Medicaid billing but at much lower total revenue.
Concentration risk and operational implications: because $22.4M of the provider’s lifetime revenue is Medicare and the top three Medicare codes make up 28.8% of Medicare revenue, the business is materially dependent on a short list of high‑value sequencing assays for its revenue profile. Combined with the modest absolute size of Medicaid revenue ($324.8K) and the heavy Medicaid concentration in a few drug‑testing codes (68.7% by the top three), this profile suggests revenue sensitivity to changes in Medicare sequencing demand, reimbursement or referral patterns, while Medicaid exposure is limited but concentrated in lower‑paid testing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
88 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 2,800 | $660 | $1.9M |
| 81307 | The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene. | 2,750 | $660 | $1.8M |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 2,840 | $630 | $1.8M |
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 1,740 | $830 | $1.4M |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 2,370 | $590 | $1.4M |
| 81238 | The lab analyst performs the technical lab test to analyze the full gene sequence of the coagulation factor IX (F9) gene. | 2,170 | $590 | $1.3M |
| 81325 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the peripheral myelin protein 22, or PMP22, gene. | 1,690 | $750 | $1.3M |
| 81223 | The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR. | 2,200 | $490 | $1.1M |
| 81302 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the methyl CpG binding protein 2, or MECP2 gene. | 1,860 | $520 | $961.1K |
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 390 | $1,790 | $690.2K |
Showing 1–10 of 88
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 88 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
88 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81325 | 1 | 10 | 1,490 | $750 | $1.1M |
| 81302 | 1 | 10 | 1,860 | $520 | $961.7K |
| 81238 | 1 | 10 | 1,290 | $590 | $816K |
| 81185 | 1 | 10 | 890 | $830 | $734.4K |
| 81249 | 1 | 10 | 830 | $590 | $692.2K |
| 81307 | 1 | 10 | 910 | $660 | $635.4K |
| 81317 | 1 | 10 | 60 | $660 | $511.5K |
| 81298 | 1 | 10 | 60 | $630 | $489.5K |
| 81223 | 1 | 10 | 830 | $490 | $467.8K |
| 81274 | 1 | 10 | 1,640 | $270 | $441.2K |
Showing 1–10 of 88
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.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 2,470 | $40 | $99K |
| 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… | 700 | $110 | $74.8K |
| 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… | 610 | $80 | $48.6K |
| 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… | 490 | $90 | $44.2K |
| 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… | 280 | $110 | $31.2K |
| 81307 | The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene. | 40 | $80 | $3.5K |
| 82542 | The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using column chromatography and possibly mass spectrometry. | 160 | $20 | $3.3K |
| 81404 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 5 molecular pathology code. | 70 | $40 | $2.6K |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 60 | $40 | $2.1K |
| 81405 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 6 molecular pathology code. | 60 | $40 | $2K |
Showing 1–10 of 37
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
37 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 21 | 30 | 2,020 | $110 | $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. | 90 | 150 | 3,680 | $30 | $1.5M |
| 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… | 26 | 40 | 1,690 | $70 | $1.4M |
| 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… | 77 | 110 | 1,810 | $50 | $930.1K |
| 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… | 20 | 30 | 1,680 | $80 | $883.5K |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 5 | 10 | 50 | $520 | $493.7K |
| 81405 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 6 molecular pathology code. | 6 | 10 | 60 | $260 | $217.4K |
| 81404 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 5 molecular pathology code. | 4 | 10 | 70 | $170 | $179.2K |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 5 | 10 | 60 | $260 | $144.8K |
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 5 | 10 | 60 | $240 | $131.6K |
Showing 1–10 of 37
Other providers in the same ZIP code as Cliffside Labs L.L.C., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| The Arc Middlesex County | NJ | Community/Behavioral Health Agency | $0 | $73M |
| Vidhata Genomics LLC | NJ | Clinical Molecular Genetics Physician | $127.3K | $616.2K |
| Tiffany Bautista | NJ | Occupational Therapist | $295.6K | $0 |
| Genophyll Enterprises LLC | NJ | Clinical Medical Laboratory | $46K | $206.9K |
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