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NPI 1568405793 · Patillas, PR · Clinical Medical Laboratory
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Laboratorio Clinico Y Bacteriologico Genesis Inc. is a clinical medical laboratory provider located in Patillas, Puerto Rico. This profile covers 34 Medicare and 144 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 | Laboratorio Clinico Y Bacteriologico Genesis Inc. |
| Address | Guillermo Riefkhol St. #2 |
| City | Patillas |
| State | PR |
| ZIP | 00723 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.5M |
| Medicare | $32.9K |
This provider is heavily Medicaid‑focused: lifetime Medicaid revenue is $7.5M compared with Medicare revenue of $32.9K, indicating the bulk of billings and cash flow come from Medicaid rather than Medicare. The scale gap shows the organization operates principally as an in‑state lab serving Medicaid populations rather than as a national Medicare lab operator.
Medicare revenue is moderately concentrated: the top 3 Medicare codes account for 33.6% of this provider's total Medicare revenue. Those top Medicare drivers include 36415 ($4.1K), 84443 ($3.5K) and 80061 ($3.1K), which together point to routine phlebotomy and basic metabolic/lipid panel work being material to the small Medicare book of business.
Medicaid revenue is also concentrated by a small set of services: the top 3 Medicaid codes account for 31.7% of Medicaid revenue. In particular, 84443 ($817.8K), 87426 ($622K) and G2023 ($610.9K) are major contributors, demonstrating that thyroid testing, high‑volume SARS‑CoV‑2 immunoassays, and specimen collection are primary revenue drivers on the Medicaid side.
Code mix and service line profile reflect a full‑service clinical laboratory with high volumes of routine chemistry/hematology and infectious disease testing. Frequent billing for 80061, 80053, 85025, 83036, 82306 and urine/albumin tests (e.g., 81000, 82043) indicates core offerings are lipid/CMP/BMP panels, CBCs, A1C and vitamin D, while numerous STD and viral PCR/antigen codes (e.g., 87426, 87635, U0002, 87491, 87591) show substantial infectious‑disease testing capacity.
In Medicaid comparisons the provider is a major in‑state player: multiple high‑revenue Medicaid codes are labeled as “extreme outlier, far above typical state volume” and sit at top ranks (for example, 84443 ranks #5 of 771 providers in‑state, 99th percentile; 80061 ranks #5 of 810, 100th percentile; 85025 ranks #5 of 849, 100th percentile; and 86702 ranks #1 of 32, 100th percentile). These rankings indicate dominant throughput for many routine tests within Puerto Rico’s Medicaid network.
By contrast, Medicare performance is modest and broadly described as typical or unremarkable at the national level: 36415 ranks #9191 of 86467 (89th percentile; typical, unremarkable volume), 84443 ranks #3995 of 19722 (80th percentile; typical), and 80061 ranks #5074 of 21671 (76th percentile; typical). This pattern shows the provider does not appear to be a major national Medicare laboratory despite handling routine testing for Medicare patients locally.
The provider shows a pronounced COVID/respiratory testing footprint in Medicaid: high Medicaid revenues for 87426 ($622K), 87635 ($514K), G2023 ($610.9K) and 86328 ($108K) combined with state percentiles in the high 90s indicate sustained, high‑volume SARS‑CoV‑2 testing and specimen collection activity. Those volumes imply the lab scaled or maintained testing capacity for public‑health demand in the Medicaid population.
The NPI has long tenure—enumerated on 2006-06-14 (~20 years ago)—which, together with the very large Medicaid volumes, suggests an established laboratory presence and sustained billing relationships in‑state. Given the longevity and the Medicaid concentration, analysts should treat this entity as a longstanding, Medicaid‑centric clinical laboratory operation when considering network contracting or competitive dynamics.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
34 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. | 510 | $10 | $4.1K |
| 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… | 220 | $20 | $3.5K |
| 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. | 240 | $10 | $3.1K |
| 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… | 370 | $10 | $2.9K |
| 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… | 80 | $30 | $2.4K |
| 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. | 230 | $10 | $2.3K |
| 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).… | 150 | $10 | $1.5K |
| 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,… | 40 | $40 | $1.3K |
| 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… | 20 | $50 | $1.1K |
| 81000 | The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen… | 270 | $1 | $1.1K |
Showing 1–10 of 34
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 34 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.
144 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… | 51,110 | $20 | $817.8K |
| 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,… | 17,280 | $40 | $622K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 25,450 | $20 | $610.9K |
| 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. | 50,130 | $10 | $601.6K |
| 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… | 10,080 | $50 | $514K |
| 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. | 44,380 | $10 | $443.8K |
| 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… | 54,300 | $10 | $380.1K |
| 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… | 12,680 | $30 | $342.4K |
| 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).… | 25,180 | $10 | $226.6K |
| 87804 | The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings. | 13,080 | $10 | $183.1K |
Showing 1–10 of 144
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
144 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. | 38 | 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,… | 8 | 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. | 30 | 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… | 5 | 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 | 5 | 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… | 9 | 370 | 370 | $50 | $63.3K |
| 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… | 4 | 10 | 180 | $30 | $63.1K |
| 87590 | The lab analyst performs a test for Neisseria gonorrhoeae, a bacteria, using direct nucleic acid probe technique. | 48 | 80 | 150 | $20 | $59.4K |
| 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. | 5 | 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. | 22 | 290 | 170 | $30 | $43.8K |
Showing 1–10 of 144
Other providers in the same ZIP code as Laboratorio Clinico Y Bacteriologico Genesis Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Centro Servicios Primarios De Salud De Patillas Inc. | PR | Federally Qualified Health Center (FQHC) | $0 | $3.1M |
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