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NPI 1548280852 · Allentown, PA · Clinical Medical Laboratory
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Health Network Laboratories, LLC is a clinical medical laboratory provider located in Allentown, Pennsylvania. This profile covers 434 Medicare and 310 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 | Health Network Laboratories, LLC |
| Address | 794 Roble Rd |
| City | Allentown |
| State | PA |
| ZIP | 18109 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $47.5M |
| Medicare | $12.5M |
HEALTH NETWORK LABORATORIES, LLC’s revenue is dominated by Medicaid at $47.5M versus $12.5M from Medicare, indicating a payer mix heavily weighted to Medicaid services and suggesting the provider’s operations prioritize or contract extensively with state Medicaid programs. This imbalance makes Medicaid the primary revenue driver for the lab’s scale and strategic positioning in Pennsylvania.
The provider’s code mix is consistent with a full‑service clinical medical laboratory that performs very high volumes of specimen collection and routine chemistry/hematology panels: Medicare shows large volumes for 36415 (142.9K claims, $1.1M revenue), 80053 (90.4K claims, $904K revenue) and 85025 (78K claims, $624.1K revenue). On the Medicaid side, the top activity centers on high-throughput molecular testing (U0003 117.2K claims, $9.1M revenue) alongside broad screening panels such as 80050 (47.6K claims, $2M revenue), indicating both centralized lab processing and extensive front‑end collection.
Revenue concentration on Medicare is substantial: the top 3 Medicare codes account for 33.6% of the provider’s Medicare revenue, led by 36415 at $1.1M (13.7%), 80053 at $904K (10.8%), and 88305 at $763.8K (9.1%). This concentration shows a reliance on high-volume phlebotomy and core lab panels plus surgical pathology interpretation as key Medicare revenue drivers.
Medicaid revenue is similarly concentrated: the top 3 Medicaid codes account for 37.4% of Medicaid revenue, dominated by U0003 at $9.1M (25.6%), followed by 87636 at $2.2M (6.3%) and 80050 at $2M (5.5%). The prominence of U0003 and other molecular respiratory codes signals major throughput in high‑paid molecular assays within the Medicaid book of business.
On competitive standing for Medicare services, the provider ranks as a national volume leader on many common lab codes — for example 36415 ranks #32 of 86467 providers (100th percentile, extreme outlier), 80053 ranks #44 of 26416 (100th percentile, extreme outlier), and 88305 ranks #45 of 14580 (100th percentile, extreme outlier). These percentile and rank positions indicate the lab is an outlier far above typical national volumes for multiple routine and pathology services, consistent with a large centralized processing footprint.
Within Pennsylvania Medicaid, the lab is a dominant state player for molecular testing and several high‑value assays: U0003 ranks #3 of 197 providers in-state (99th percentile, extreme outlier), 87636 ranks #1 of 73 providers (100th percentile, extreme outlier), and 88305 ranks #2 of 487 providers in-state (100th percentile, extreme outlier). These ranks and the large absolute Medicaid dollar amounts suggest the lab captures outsized state market share for COVID/SARS‑CoV‑2 and respiratory multiplex testing as well as surgical pathology services.
The provider’s service mix includes specialized and higher‑complexity testing alongside routine panels: Medicare lists 81455 (39 claims, $111.5K revenue) and Medicaid lists 81420 ($1.5M revenue), while multiple pathology codes (88305, 88307, 88342, 88341) appear on both payers’ top lists. This combination of genomic panels and level IV/V surgical pathology services implies capability in molecular/genomic testing and advanced histopathology interpretation, not just high‑volume screening.
Operationally, the lab shows extensive specimen collection and outreach activity: Medicare lists P9604 with 33.3K claims ($200K revenue) and G0471 with 22.4K claims ($224.3K revenue), reflecting frequent one‑way travel allowances and venipuncture collections from skilled nursing facilities or homebound patients. Those volumes, combined with the high testing throughput, imply significant logistics for mobile collection and service lines oriented toward SNFs and home health agency specimens.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
434 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. | 142,930 | $10 | $1.1M |
| 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. | 90,400 | $10 | $904K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 27,280 | $30 | $763.8K |
| 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… | 42,510 | $20 | $680.2K |
| 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. | 49,950 | $10 | $649.4K |
| 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… | 78,010 | $10 | $624.1K |
| 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… | 19,150 | $30 | $555.4K |
| 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).… | 35,270 | $10 | $352.7K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 32,190 | $10 | $257.5K |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 22,430 | $10 | $224.3K |
Showing 1–10 of 434
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 434 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
434 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87798 | 33 | 40 | 1,250 | $30 | $1.1M |
| G0471 | 1 | 10 | 17,570 | $10 | $148.1K |
| 87799 | 3 | 10 | 790 | $40 | $128.8K |
| 81514 | 3 | 10 | 130 | $260 | $119.1K |
| 87505 | 2 | 10 | 900 | $130 | $112.5K |
| 87529 | 6 | 10 | 80 | $30 | $96.6K |
| G0480 | 5 | 40 | 270 | $110 | $94.5K |
| 87641 | 7 | 30 | 120 | $30 | $84.2K |
| 81455 | 1 | 10 | 30 | $2,810 | $81.5K |
| 87493 | 3 | 10 | 110 | $40 | $79.7K |
Showing 1–10 of 434
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.
310 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 117,160 | $80 | $9.1M |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 21,180 | $110 | $2.2M |
| 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… | 47,630 | $40 | $2M |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 13,400 | $140 | $1.8M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 71,890 | $20 | $1.7M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 46,270 | $40 | $1.7M |
| 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. | 28,500 | $60 | $1.6M |
| 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,… | 2,630 | $580 | $1.5M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 64,820 | $20 | $1.5M |
| 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… | 41,570 | $30 | $1.4M |
Showing 1–10 of 310
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
310 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 19 | 20 | 710 | $80 | $1.7M |
| 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… | 11 | 130 | 310 | $60 | $769.3K |
| 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. | 12 | 210 | 730 | $40 | $689.7K |
| 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,… | 3 | 10 | 1,270 | $340 | $567.5K |
| 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… | 3 | 200 | 990 | $70 | $517.5K |
| 0202U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the… | 32 | 60 | 430 | $200 | $354.2K |
| 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… | 5 | 10 | 470 | $260 | $227K |
| 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 | 70 | $150 | $154.4K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 26 | 60 | 110 | $220 | $151.2K |
| 87800 | The lab analyst performs a test for multiple infectious organisms in one sample using direct nucleic acid probe technique. | 1 | 10 | 530 | $20 | $139.6K |
Showing 1–10 of 310
Other providers in the same ZIP code as Health Network Laboratories, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bayada Home Health Care, Inc. | PA | Home Health Agency | $0 | $23.3M |
| Haven House | PA | Adult Mental Health Clinic/Center | $0 | $10.6M |
| Zhiming Yang | PA | Anatomic Pathology Physician | $4.5M | $0 |
| Gong Feng | PA | Anatomic Pathology & Clinical Pathology Physician | $95.2K | $0 |
| Winfred Ferolin | PA | Physical Therapist | $86.4K | $0 |
| Chau Nguyen | PA | Family Medicine Physician | $46.3K | $0 |
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