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NPI 1598266421 · Birmingham, AL · Clinical Medical Laboratory
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Core Diagnostic Laboratories LLC is a clinical medical laboratory provider located in Birmingham, Alabama. This profile covers 106 Medicare and 158 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 | Core Diagnostic Laboratories LLC |
| Address | 211 Summit Pkwy Ste 124 |
| City | Birmingham |
| State | AL |
| ZIP | 35209 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 26, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $44.2M |
| Medicare | $1.3M |
CORE DIAGNOSTIC LABORATORIES LLC appears to operate primarily as a high-volume molecular and infectious disease testing laboratory, with its top Medicare and Medicaid codes dominated by nucleic acid amplification and multiplex respiratory panels (examples include 87631, 87635, 87633, 87634) and broad amplified probe codes such as 87798. The mix of high-volume multiplex viral testing and COVID-specific codes (U0004, 87635) alongside broad amplified-probe categories indicates a service model focused on centralized, high-throughput infectious pathogen diagnostics rather than routine chemistry-only outpatient lab services.
Medicaid revenue at CORE DIAGNOSTIC LABORATORIES LLC substantially exceeds Medicare revenue in scale: Total Medicaid revenue is $44.2M versus total Medicare revenue of $1.3M, indicating the provider is effectively Medicaid-dominant by dollars. This payer mix suggests most of the lab’s contractual and operational focus, specimen volume, and reimbursement dependency is at the state Medicaid level rather than Medicare.
Revenue concentration is high on both payers but especially on Medicaid: the precomputed top 3 Medicaid codes account for 64.8% of the provider’s total Medicaid revenue, driven by 87798 (34.8%) and 87633 (22.1%). On Medicare, the top 3 codes account for 54.6% of Medicare revenue, with G0482 alone contributing 36.7% of Medicare revenue. These concentrations imply that a small set of test families — amplified nucleic acid probe testing and definitive drug testing — drive the majority of payments for each payer.
Competitive standing differs by payer and code. For Medicaid, CORE is frequently a leading in-state performer — for example it ranks #2 in Alabama for 87798 and 87633 and ranks #1 in-state for U0004, 87634, 87498, 87653 and multiple other codes where the descriptor labels are “extreme outlier” or “notably above typical state volume.” This pattern characterizes the lab as a dominant statewide provider for scaled respiratory and SARS-CoV-2 testing. For Medicare, rankings are more mixed: G0482 ranks #24 nationally (99th percentile) indicating unusually high national volume for definitive drug testing, while many other Medicare code ranks are high-percentile but described as “typical, unremarkable volume,” so the lab is a meaningful national player on a few specific codes rather than broadly dominant across Medicare.
Several specific codes present statistical outlier behavior that signals specialized capacity. On Medicare, 85049 and 82010 are described as “extreme outlier, far above typical national volume,” and 84311 ranks #3 nationally (97th percentile) which suggests unusually large volumes in certain hematology/chemistry assays relative to national peers. On Medicaid, multiple codes including U0004, 87634, 87502, 87498, 87635, 87653, 87640 and G0482 are labeled “extreme outlier” or “notably above typical state volume,” reinforcing that the lab handles very large Medicaid testing volumes for SARS-CoV-2, multiplex respiratory panels, meningitis testing, and definitive drug testing within Alabama.
The lab’s taxonomy and tenure support this operational profile: as a Clinical Medical Laboratory with NPI enumerated on 2018-02-26 (~8 years ago), CORE DIAGNOSTIC LABORATORIES LLC has several years of established claims history to build the high Medicaid volumes observed. The combination of a clinical laboratory taxonomy and multi-year enumeration aligns with the high-throughput molecular and confirmatory testing footprint shown in the code mix.
Business implications for payers and network planners: given the heavy Medicaid concentration and the fact that a handful of codes produce the majority of revenue (Medicaid top-3 = 64.8%; Medicare top-3 = 54.6%), contracting or utilization-management strategies focused on multiplex respiratory panels, SARS-CoV-2 testing, and amplified-probe categories would capture the majority of this provider’s activity. Payers evaluating lab networks in Alabama should consider CORE as a major state-level capacity source for high-throughput infectious disease and COVID-era testing.
Operational risk and network redundancy considerations emerge from the provider’s concentrated role in state testing capacity. Because many Medicaid-listed codes are ranked extremely high in-state (including several #1 rankings), any change to contracts, lab access, or capacity at CORE could materially affect in-state access to high-volume respiratory and SARS-CoV-2 testing; payers may want redundancy planning for these specific test families.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
106 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0482 | 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… | 2,580 | $170 | $438.6K |
| 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,… | 1,350 | $120 | $165.4K |
| 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. | 1,790 | $30 | $48.4K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 650 | $70 | $47.5K |
| 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. | 4,200 | $10 | $42K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,140 | $30 | $38.8K |
| 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. | 630 | $60 | $37.8K |
| 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… | 750 | $50 | $37.5K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 1,000 | $30 | $34.1K |
| 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… | 2,070 | $20 | $33K |
Showing 1–10 of 106
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 106 CPT/HCPCS codes.
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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.
158 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… | 115,110 | $130 | $15.1M |
| 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… | 74,820 | $130 | $9.6M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 91,530 | $40 | $3.4M |
| 87634 | The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique. | 66,620 | $20 | $1.6M |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 90,340 | $20 | $1.4M |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 51,330 | $30 | $1.4M |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 84,340 | $20 | $1.3M |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 80,780 | $20 | $1.3M |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 88,540 | $10 | $1.2M |
| 87498 | A lab tests a patient’s specimen to provide a definitive diagnosis of meningitis by amplified probe technique. | 79,690 | $10 | $1M |
Showing 1–10 of 158
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
158 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 | 60 | 1,260 | $60 | $1.2M |
| 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… | 2 | 100 | 470 | $130 | $1.2M |
| 82010 | The lab analyst performs the technical lab test to analyze quantitative ketone bodies, typically in serum or plasma. The quantitative test is to determine a number value, not just a positive or… | 2 | 10 | 2,320 | $10 | $1M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 1 | 20 | 10,040 | $40 | $825.9K |
| 87507 | The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal… | 2 | 10 | 1,020 | $110 | $784.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 3 | 40 | 450 | $20 | $591.3K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 3 | 40 | 460 | $20 | $584.1K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 4 | 40 | 1,540 | $10 | $397.4K |
| 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… | 14 | 40 | 430 | $10 | $391.5K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 18 | 20 | 1,500 | $20 | $389.4K |
Showing 1–10 of 158
Other providers in the same ZIP code as Core Diagnostic Laboratories LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Lab Works, LLC | AL | Clinical Medical Laboratory | $738.4K | $41.6M |
| Valentines Home Care, Inc. | AL | Durable Medical Equipment & Medical Supplies | $0 | $13.6M |
| Devansh Lab Werks,inc | AL | Clinical Medical Laboratory | $1.9M | $5.9M |
| Grayson And Associates PC | AL | Psychiatry Physician | $0 | $5M |
| Affinity Acquisitions, LLC | AL | Community Based Hospice Care Agency | $0 | $4.8M |
| Metro Pediatrics PC | AL | Specialist | $0 | $4.5M |
| Birmingham Radiological Group PC | AL | Diagnostic Radiology Physician | $0 | $3.5M |
| Proteus Molecular And Clinical Lab LLC | AL | Clinical Medical Laboratory | $236.9K | $3.2M |
| Greg Eudy | AL | Rheumatology Physician | $3.3M | $0 |
| Luigi Bertoli | AL | Hematology (Internal Medicine) Physician | $2.8M | $0 |
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