Loading...
NPI 1588712020 · Richmond, CA · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Genetic Disease Screening Program, State Of Ca is a clinical medical laboratory provider located in Richmond, California. This profile covers 0 Medicare and 6 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 | Genetic Disease Screening Program, State Of Ca |
| Address | 850 Marina Bay Pkwy # G-272 |
| City | Richmond |
| State | CA |
| ZIP | 94804 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 8, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $182.6M |
| Medicare | $0 |
This provider is effectively single‑payer in the available data: there is no Medicare billing on file and all reported clinical revenue is Medicaid-based, totaling $182.6M. The absence of Medicare activity suggests the entity operates primarily within public health or state-funded programs rather than as a fee-for-service Medicare lab supplier.
Revenue is highly concentrated in a narrow set of prenatal/genetic assays: the precomputed top three codes 81508, 81511, and 81420 together account for 88.4% of the provider’s Medicaid revenue. Individually those lines are large contributors: 81508 generated $83M (45.5%), 81511 generated $50.6M (27.7%), and 81420 generated $27.8M (15.2%) of total Medicaid revenue.
The code mix indicates a core business focused on prenatal and fetal genetic screening: 81508 and 81511 are algorithmic maternal serum risk scores using analytes such as PAPP‑A, hCG, AFP and uE3, while 81420 is a cfDNA genomic sequence analysis panel for fetal aneuploidy (chromosomes 13, 18, 21). This combination of large volumes across serum‑based risk algorithms and cfDNA sequencing is consistent with a centralized prenatal screening laboratory that processes high throughput samples for population-level programs.
Competitive standing varies by code: the provider ranks #1 of 5 for 81508 at the 100th percentile and is described as notably above typical state volume, indicating market leadership for that maternal serum screen. For 81511 the provider is #1 of 3 at the 100th percentile but described as typical/unremarkable volume for the state, while for 81420 it ranks #6 of 32 at the 84th percentile, showing strong but not exclusive share of in‑state cfDNA testing.
There are distinct outlier signals in non‑top‑3 tests that further characterize the provider’s scope. 82105 (quantitative alpha‑fetoprotein) produced $14.5M (7.9% of Medicaid revenue) and ranks #1 of 186 at the 100th percentile, labeled an extreme outlier far above typical state volume—this points to unusually high AFP testing throughput relative to peers.
The provider also performs specialized and proprietary assays: 0327U (a PLA for Vasistera™) accounts for $6M (3.3% of Medicaid revenue) and is listed #1 of 1 with a 0th percentile peer comparison (no state peer volume comparison available), indicating sole in‑state reporting for that PLA test. Additionally, newborn metabolic panel S3620 appears at smaller scale ($724.8K, 0.4% of revenue) and ranks #3 of 25 at the 92th percentile, confirming ancillary newborn screening activity.
Operationally, the combination of very large volumes in a few prenatal codes and sole‑provider PLA activity implies high throughput laboratory workflows and likely integration with state maternal/newborn screening programs or contracts. Given that the top three codes drive 88.4% of revenue, capacity, payer authorization, or reimbursement changes for those specific tests would disproportionately affect the lab’s revenue stream.
The provider has been enumerated since 2007‑01‑08 (~19 years ago), indicating a long tenure that supports an interpretation of established state or programmatic relationships rather than a recent market entrant. That longevity, coupled with concentrated Medicaid revenue ($182.6M) and dominant in‑state ranks on multiple codes, positions the entity as an entrenched Medicaid prenatal/genetic screening lab within California.
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81508 | The lab analyst performs the technical lab tests for two proteins, PAPP–A and hCG, and carries out an algorithmic analysis using patient data and the lab test results to report a patient risk score. | 375,520 | $220 | $83M |
| 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… | 229,100 | $220 | $50.6M |
| 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,… | 120,140 | $230 | $27.8M |
| 82105 | The lab analyst measures the quantitative level of the alpha–fetoprotein. This glycoprotein is produced early in fetal life, and a variety of tumors can also produce it later in life. | 170,660 | $90 | $14.5M |
| 0327U | 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 0327U only for… | 25,810 | $230 | $6M |
| S3620 | Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis;… | 4,340 | $170 | $724.8K |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
6 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,… | 6 | 30 | 300 | $260 | $18M |
| 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 | 1,270 | $220 | $16.9M |
| 81508 | The lab analyst performs the technical lab tests for two proteins, PAPP–A and hCG, and carries out an algorithmic analysis using patient data and the lab test results to report a patient risk score. | 1 | 10 | 5,070 | $210 | $16.6M |
| 0327U | 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 0327U only for… | 1 | 10 | 25,810 | $230 | $6M |
| S3620 | Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis;… | 3 | 30 | 790 | $120 | $234.1K |
| 82105 | The lab analyst measures the quantitative level of the alpha–fetoprotein. This glycoprotein is produced early in fetal life, and a variety of tumors can also produce it later in life. | 1 | 190 | 260 | $30 | $98.2K |
Other providers in the same ZIP code as Genetic Disease Screening Program, State Of Ca, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Permanente Medical Group, Inc. | CA | Clinical Medical Laboratory | $924.3K | $51.1M |
| Addiction Research And Treatment, Inc | CA | Substance Use Disorder Rehabilitation Clinic/Center | $654.9K | $3K |
| Costco Wholesale Corporation | CA | Community/Retail Pharmacy | $109.6K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.