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NPI 1528514221 · Pleasant Hill, LA · Clinical Medical Laboratory
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Victoria Healthcare Resources is a clinical medical laboratory provider located in Pleasant Hill, Louisiana. This profile covers 87 Medicare and 88 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 | Victoria Healthcare Resources |
| Address | 2300 West Second Street |
| City | Pleasant Hill |
| State | LA |
| ZIP | 71065 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 1, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $7.9M |
| Medicaid | $1.2M |
VICTORIA HEALTHCARE RESOURCES is predominantly a Medicare-billed laboratory business: reported lifetime Medicare revenue is $7.9M compared with $1.2M in Medicaid, indicating Medicare accounts for the bulk of reported public-payer volume and dollars. This payer mix suggests the provider’s core revenue engine is Medicare-focused lab work rather than a Medicaid-centric operation.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 60.8% of the provider’s Medicare revenue, driven by 87798 (87.7K claims, $3M revenue; 39.2% of Medicare revenue), P9603 (1.1M claims, $1.1M revenue; 14.4%), and 36415 (68.7K claims, $549.7K revenue; 7.2%). Together these codes point to a business model that mixes high-volume molecular/NAAT testing (87798) with extensive specimen collection logistics (P9603) and routine phlebotomy (36415).
The procedure mix indicates a specialty in amplified nucleic acid probe infectious-disease testing alongside broad clinical lab services: multiple NAAT codes appear prominently (for example 87641, 87500, 87640, 87481) and 87798 alone generates $3M in Medicare revenue. Several of those NAAT codes rank in high national percentiles (for example 87641 ranks #8 of 671, 99th percentile; 87500 ranks #8 of 838, 99th percentile), signaling the provider operates at substantial scale for infectious-agent molecular testing relative to national peers.
On the Medicaid side the provider also shows concentrated, high-volume routine testing: the precomputed top 3 Medicaid codes account for 34.6% of Medicaid revenue, with 85025 (203.1K claims, $203.1K; 15.6%), 80053 (139.2K claims, $139.2K; 10.7%), and 80050 ($107.6K revenue; 8.3%) leading. That mix — CBCs, CMPs, and general health panels — and very large claim counts indicate the lab is a major in-state destination for standard outpatient screening and monitoring tests for Medicaid enrollees.
The provider’s competitive standing is strong on many high-volume codes both nationally and in-state: Medicare-side 36415 is an "extreme outlier" (ranks #58 of 86,467, 100th percentile) and 87798 ranks #19 of 1,319 (99th percentile), while Medicaid-side 85025 ranks #3 of 379 in-state (99th percentile, "extreme outlier") and 83036 ranks #2 of 366 in-state (100th percentile, "extreme outlier"). These rankings characterize the organization as a dominant or major player for multiple routine and molecular tests in its competitive sets rather than a modest or occasional provider.
Operational footprint appears to include extensive specimen-collection services: P9603 shows 1.1M claims and $1.1M in Medicare revenue and ranks #12 of 267 nationally (96th percentile). The prominence of P9603 (travel allowance for specimen collection) combined with high volumes in 36415 and urine testing codes suggests active outreach/phlebotomy to homebound or nursing-home patients and sizable logistics for specimen pickup.
Tenure in the provider file is non-trivial: the NPI was enumerated 2016-09-01 (~10 years ago), indicating roughly a decade of billing history available to payers and competitors for performance review and network decisions. That tenure, coupled with sustained high-volume code rankings, supports treating current patterns as established rather than transient.
Multiple specific codes are flagged as unusually high-volume in plain-English terms and therefore merit operational review during contracting or utilization analyses: examples include Medicare 36415 (100th percentile, "extreme outlier"), Medicare 87641 and 87500 (both 99th percentile, "extreme outlier"), and Medicaid 85025 and 83036 (both 99–100th percentile, "extreme outlier"). These repeated high-percentile and outlier labels across different code families (NAAT, routine panels, drug/therapeutic monitoring) indicate a concentrated, high-throughput laboratory operation whose service lines and capacity should be considered when assessing network adequacy or competitive impact.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
87 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 87,680 | $30 | $3M |
| 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 | 1,092,750 | $1 | $1.1M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 68,720 | $10 | $549.7K |
| 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… | 38,580 | $10 | $308.6K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 8,780 | $30 | $298.5K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 8,770 | $30 | $298.1K |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 8,770 | $30 | $298.1K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 8,600 | $30 | $292.5K |
| 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. | 28,070 | $10 | $280.7K |
| 81007 | The analyst uses a nonculture, nondipstick method to determine whether bacteriuria is present or absent. The specimen typically would be from a random urine collection. | 9,090 | $30 | $263.6K |
Showing 1–10 of 87
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 87 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.
88 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 203,080 | $1 | $203.1K |
| 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. | 139,190 | $1 | $139.2K |
| 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… | 3,360 | $30 | $107.6K |
| 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… | 81,090 | $1 | $81.1K |
| 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… | 24,230 | $1 | $72.7K |
| 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).… | 64,150 | $1 | $64.1K |
| 80164 | The lab analyst measures the amount of total valproic acid, also called dipropylacetic acid, in the blood. Valproic acid is a drug that a provider uses to treat certain types of seizures. | 28,430 | $1 | $56.9K |
| 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… | 55,980 | $1 | $56K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 18,380 | $1 | $55.2K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 18,380 | $1 | $55.1K |
Showing 1–10 of 88
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
88 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2 | 90 | 650 | $40 | $404.2K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 2 | 20 | 690 | $20 | $359.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 3 | 50 | 530 | $20 | $237.6K |
| 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. | 5 | 270 | 3,140 | $10 | $111K |
| 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… | 33 | 140 | 810 | $30 | $106.6K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 2 | 20 | 850 | $20 | $79.4K |
| 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… | 3 | 380 | 1,730 | $1 | $64.6K |
| 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… | 4 | 170 | 330 | $20 | $41.5K |
| 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… | 3 | 190 | 720 | $10 | $38.2K |
| 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. | 3 | 260 | 780 | $10 | $37K |
Showing 1–10 of 88
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