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NPI 1518903350 · Miramar, FL · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Miramar, Florida. This profile covers 556 Medicare and 599 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 | 10200 Commerce Pkwy |
| City | Miramar |
| State | FL |
| ZIP | 33025 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $197.6M |
| Medicare | $42.2M |
Payer mix and scale: QUEST DIAGNOSTICS CLINICAL LABORATORIES INC reports $42.2M in lifetime Medicare revenue and $197.6M in lifetime Medicaid revenue, indicating Medicaid is the materially larger payer relationship on file. Both payers are active for this NPI, so analysis should treat the provider as a high-volume Medicaid-focused laboratory operation with meaningful Medicare activity as well.
Medicare revenue concentration: the provider’s top 3 Medicare codes account for 35.1% of its total Medicare revenue, led by 80053 ($3.4M), 80061 ($3.3M) and 84443 ($3.2M). This concentration shows that a relatively small set of routine chemistry and endocrine assays drive a large share of Medicare billings.
Medicaid revenue concentration: the top 3 Medicaid codes account for 26.6% of total Medicaid revenue, with 87491 ($11.5M), U0003 ($11M) and 81420 ($10.7M) as the largest contributors. These top Medicaid drivers blend high-volume infectious disease and molecular/genomic testing alongside population screening services.
Business and service-line footprint: the code mix shows a full-service clinical laboratory that processes both high-volume routine tests (80053, 80061, 85025, 83036, 84443, 82306) and higher-complexity molecular/genetic assays (U0003, 81420, 81220). The presence of large claim counts for STD and infectious-disease nucleic acid tests (87491, 87591, U0003) plus cytology and genomic panels (, ) suggests centralized, high-throughput specimen processing across ambulatory and public-health testing lines.
Medicare competitive standing: nationally this provider ranks at extreme outlier levels on many routine lab codes — for example 80053 ranks #16 of 26416 (100th percentile), 80061 ranks #14 of 21671 (100th percentile), and 84443 ranks #15 of 19722 (100th percentile). These high ranks and frequent “extreme outlier” labels indicate volumes far above typical national peers for core chemistry and endocrine testing.
Medicaid/state competitive standing: within Florida the provider is consistently a top in-state performer on key codes — 87491 ranks #2 of 343 (100th percentile), U0003 ranks #2 of 320 (100th percentile), 86003 ranks #1 of 18 (100th percentile), and many routine panels (80061, 80053, 84443, 82306) also rank in the 100th percentile. This pattern establishes the lab as a dominant statewide participant for STD screening, molecular COVID testing, and routine panel processing.
Tenure and operational implications: the NPI was enumerated on 2006-06-21 (~20 years ago), indicating long-standing enrollment in federal programs and likely established laboratory infrastructure and payer relationships. Combined with the high-volume code mix and outsized ranks, tenure supports the conclusion that this is an established commercial laboratory operation rather than a new entrant.
Statistical outliers and operational inference: many high-volume codes are explicitly labeled “extreme outlier” or “notably above typical,” which is consistent across both Medicare and Medicaid for core panels and infectious/molecular tests (examples include 80053, 80061, 82306, 84443, 87491, U0003). Taken together, the outlier labels and large claim counts suggest centralized, high-throughput processing capacity and a business model built around scale in both routine and specialized diagnostic 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.
556 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. | 341,170 | $10 | $3.4M |
| 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. | 253,290 | $10 | $3.3M |
| 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… | 200,190 | $20 | $3.2M |
| 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… | 99,530 | $30 | $2.9M |
| 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… | 280,180 | $10 | $2.2M |
| 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).… | 166,760 | $10 | $1.7M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 198,260 | $10 | $1.6M |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 84,740 | $20 | $1.3M |
| 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… | 54,040 | $20 | $972.8K |
| 82746 | The lab analyst measures the folic acid level in serum to determine if there is a deficiency. Folic acid deficiency is attributed to many conditions such as malabsorption, Crohn’s disease, celiac… | 58,370 | $10 | $817.1K |
Showing 1–10 of 556
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 556 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
556 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81450 | 4 | 10 | 20 | $740 | $322.2K |
| 87798 | 74 | 110 | 590 | $30 | $218.6K |
| 87801 | 13 | 60 | 450 | $70 | $166.5K |
| 83521 | 5 | 10 | 3,990 | $20 | $163.5K |
| 81339 | 17 | 30 | 110 | $180 | $116.4K |
| 83013 | 2 | 10 | 1,640 | $70 | $107K |
| 81279 | 23 | 30 | 140 | $180 | $106.7K |
| 83698 | 2 | 10 | 240 | $50 | $104.5K |
| 87536 | 2 | 10 | 90 | $80 | $100.3K |
| 83704 | 2 | 10 | 250 | $30 | $100K |
Showing 1–10 of 556
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.
599 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. | 677,730 | $20 | $11.5M |
| 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… | 135,260 | $80 | $11M |
| 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,… | 30,000 | $360 | $10.7M |
| 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. | 1,450,930 | $10 | $8.7M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 670,550 | $10 | $7.4M |
| 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… | 27,030 | $260 | $7.1M |
| 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… | 507,400 | $10 | $6.6M |
| 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… | 1,060,800 | $10 | $6.4M |
| 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. | 1,683,210 | $1 | $5M |
| 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… | 1,634,250 | $1 | $4.9M |
Showing 1–10 of 599
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
599 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,… | 2 | 10 | 8,980 | $280 | $4.2M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 3 | 10 | 80 | $50 | $2.4M |
| 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… | 3 | 20 | 130 | $210 | $1.5M |
| 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… | 2 | 10 | 28,880 | $30 | $1.4M |
| 83498 | The lab analyst measures the 17 hydroxyprogesterone in a sample such as blood, serum, urine, or even amniotic fluid. This hormone is a building block for the adrenal cortex hormone cortisol. | 3 | 10 | 7,990 | $10 | $932.8K |
| 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 | 40 | 320 | $100 | $620K |
| 81511 | The lab analyst performs the technical lab tests for four analytes, AFP, uE3, hCG, and DIA, and carries out an algorithmic analysis using patient data and the lab test results to report a patient… | 1 | 10 | 9,150 | $60 | $584.1K |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 1 | 10 | 680 | $270 | $506.2K |
| 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… | 1 | 20 | 620 | $30 | $423.4K |
| 80055 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen, a rubella antibody, a qualitative non… | 1 | 10 | 170 | $40 | $366K |
Showing 1–10 of 599
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 |
|---|---|---|---|---|
| Integrated Home Care Services, Inc. | FL | Case Management Agency | $0 | $176.6M |
| Dade Medical, Inc. | FL | Durable Medical Equipment & Medical Supplies | $0 | $34M |
| Primary Medical Staffing, Inc. | FL | Home Health Agency | $0 | $10.9M |
| Option Care Enterprises, Inc. | FL | Home Infusion Therapy Pharmacy | $0 | $9.5M |
| Jabez Home Care LLC | FL | Home Health Agency | $0 | $7.9M |
| Matthew Taub | FL | Hematology & Oncology Physician | $271K | $165.6K |
| Richard Solomon | FL | Psychiatry Physician | $355.1K | $0 |
| Alceha Mayne Thomas | FL | Family Nurse Practitioner | $140.3K | $0 |
| Dominique Rameau | FL | Foot & Ankle Surgery Podiatrist | $122.8K | $0 |
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