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NPI 1538139662 · Caguas, PR · Clinical Medical Laboratory
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Conmed Laboratories Inc is a clinical medical laboratory provider located in Caguas, Puerto Rico. This profile covers 65 Medicare and 113 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 | Conmed Laboratories Inc |
| Address | Consolidated Medical Plaza Calle Gautier Benitez |
| City | Caguas |
| State | PR |
| ZIP | 00725 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.4M |
| Medicare | $105.5K |
Payer mix is heavily skewed toward Medicaid: lifetime Medicaid revenue is $5.4M versus total Medicare revenue of $105.5K, indicating the provider operates essentially as a Medicaid-focused laboratory with only modest Medicare billing on file. This scale difference implies contracting, service delivery, and utilization patterns are driven primarily by state programs in Puerto Rico rather than Medicare-market dynamics.
Business/service-line profile matches a high-volume clinical diagnostic laboratory: Medicare top codes include 36415 (1.5K claims, $8 avg paid/claim, $11.9K revenue) and panel tests such as 84443 and 80061, while Medicaid top codes are dominated by routine chemistry, hematology and infectious-disease assays (for example 84443: 30.7K claims, $553.2K revenue; 80053: 36K claims, $395.5K revenue; 85025: 49.7K claims, $347.8K revenue). The mix of venipuncture, panels, and nucleic-acid/antigen tests shows an operation set up for high-throughput outpatient specimen processing across a broad test menu.
Revenue concentration by top tests is moderate rather than extreme: the provider’s top 3 Medicare codes account for 35.8% of Medicare revenue and the top 3 Medicaid codes account for 30.8% of Medicaid revenue. This suggests revenue is distributed across a wide set of routine and specialty assays rather than being dominated by a single test.
Medicaid competitive standing is strong and often dominant in-state: multiple Medicaid codes rank at or near the top statewide, for example 84443 ranks #10 of 771 (99th percentile; notably above typical state volume), 80053 ranks #7 of 792 (99th percentile; extreme outlier, far above typical state volume), and 85025 ranks #6 of 849 (99th percentile; extreme outlier). These ranks indicate the provider is a major in-state source for routine panels and high-volume testing services in Puerto Rico.
Medicare footprint is modest in absolute dollars but shows above-typical volumes on specific codes nationally: total Medicare revenue is $105.5K, yet codes such as 36415 rank #1495 of 86467 (98th percentile) and 80061 ranks #913 of 21671 (96th percentile), indicating stronger-than-typical per-code activity despite small aggregate Medicare revenue. In practice this means the lab files many claims on routine tests for Medicare beneficiaries but overall Medicare represents a small revenue stream.
Large COVID and other infectious-disease testing volumes are evident on Medicaid: 87635 has 9K claims and $447.8K revenue (9.6% of Medicaid revenue), 87426 has 7.9K claims and $340.6K revenue (7.3%), and G2023 has 8.5K claims and $203.7K revenue (4.4%). By contrast Medicare shows smaller COVID-related billing (e.g., 87426: 102 claims, $3.6K revenue), indicating the provider handled substantial pandemic-era testing through Medicaid contracts or state programs.
Specimen-collection and basic diagnostic throughput are core operations: Medicare shows 36415 (venipuncture) with 1.5K claims and $11.9K revenue, and Medicaid lists G2023 (specimen collection for SARS-CoV-2) with 8.5K claims and $203.7K revenue plus high-volume urinalysis 81001 at 38.6K claims and $115.8K revenue. These numbers point to an infrastructure for widespread sample collection and routine processing across specimen types and testing modalities.
Long tenure in national enrollment may support stable operations: the provider’s NPI was enumerated on 2006-01-23 (~20 years ago), consistent with an established laboratory footprint. Combined with the heavy Medicaid revenue ($5.4M) and high in-state ranks, the profile suggests sustained, state-focused service delivery rather than a recent entrant or niche specialty 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.
65 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1,490 | $10 | $11.9K |
| 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… | 690 | $20 | $11K |
| 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. | 800 | $10 | $10.5K |
| 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. | 920 | $10 | $9.2K |
| 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… | 260 | $30 | $7.4K |
| 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… | 850 | $10 | $6.8K |
| 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).… | 530 | $10 | $5.3K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 100 | $40 | $3.6K |
| 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… | 180 | $20 | $3.3K |
| 82274 | The lab analyst uses an immunoassay method to perform a test for hidden blood in a fecal specimen that the patient collects from three consecutive bowel movements or that the clinician acquires… | 170 | $20 | $2.8K |
Showing 1–10 of 65
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 65 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.
113 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 30,740 | $20 | $553.2K |
| 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… | 8,960 | $50 | $447.8K |
| 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. | 31,160 | $10 | $436.2K |
| 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. | 35,960 | $10 | $395.5K |
| 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… | 49,690 | $10 | $347.8K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 7,920 | $40 | $340.6K |
| 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… | 11,330 | $30 | $317.3K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 8,490 | $20 | $203.7K |
| 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).… | 19,090 | $10 | $190.9K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 7,760 | $20 | $178.4K |
Showing 1–10 of 113
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
113 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 16 | 40 | 250 | $80 | $140.8K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 36 | 650 | 1,260 | $40 | $93.7K |
| 87490 | The lab analyst performs a test for Chlamydia trachomatis using direct nucleic acid probe technique. Chlamydia trachomatis causes a common sexually transmitted disease and certain eye infections. | 12 | 70 | 150 | $20 | $71.9K |
| 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… | 10 | 770 | 2,520 | $20 | $65.5K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 35 | 590 | 1,440 | $20 | $65.4K |
| 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… | 10 | 370 | 370 | $50 | $63.3K |
| 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. | 10 | 810 | 2,350 | $10 | $52.7K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 23 | 290 | 170 | $30 | $43.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 26 | 310 | 190 | $30 | $43.1K |
| 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. | 7 | 790 | 2,360 | $10 | $41.9K |
Showing 1–10 of 113
Other providers in the same ZIP code as Conmed Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
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