Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. California (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Billiontoone Inc (NPI 1598314437)

Billiontoone Inc is a clinical medical laboratory provider located in Union City, California. This profile covers 0 Medicare and 14 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Billiontoone Inc
Address	3200 Whipple Rd
City	Union City
State	CA
ZIP	94587
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	September 4, 2019

Payer Source	Total Paid
Medicaid	$78.1M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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,…	171,670	$220	$37.6M
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…	165,810	$140	$22.4M
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	163,520	$40	$6.7M
81361	The lab analyst performs the technical lab test to detect the presence of specific changes in the hemoglobin, subunit beta (HBB) gene specifically for common variants, such as HbS, HbC, HbE.	75,940	$50	$3.5M
81257	The lab analyst performs the technical lab test to detect the presence of specific changes and possible deleted nucleotides in the alpha globin 1 and alpha globin 2 genes, also known as HBA1/HBA2,…	76,630	$40	$2.7M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	11,980	$190	$2.2M
81599	Use 81599 to report a multianalyte assay with algorithmic analysis, or MAAA test, that does not have a specific Category I code or an administrative code in Appendix O.	8,390	$160	$1.3M
81403	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 4 molecular pathology code.	27,390	$30	$876.6K
81422	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s) associated with conditions such as DiGeorge…	7,610	$80	$631.4K
81455	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as tumor tissue or bone marrow, for DNA and possibly RNA alterations in 51 or more genes known to…	90	$1,190	$112.1K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Billiontoone Inc — 3 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

14 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,…	4	30	300	$260	$18M
81361	The lab analyst performs the technical lab test to detect the presence of specific changes in the hemoglobin, subunit beta (HBB) gene specifically for common variants, such as HbS, HbC, HbE.	2	10	900	$30	$1.9M
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…	3	110	190	$140	$1.6M
81422	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s) associated with conditions such as DiGeorge…	3	10	3,270	$60	$1.5M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	7	50	500	$160	$1.1M
81257	The lab analyst performs the technical lab test to detect the presence of specific changes and possible deleted nucleotides in the alpha globin 1 and alpha globin 2 genes, also known as HBA1/HBA2,…	2	10	1,960	$20	$830.3K
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	2	60	400	$40	$748.5K
81455	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as tumor tissue or bone marrow, for DNA and possibly RNA alterations in 51 or more genes known to…	4	10	80	$660	$439.2K
81599	Use 81599 to report a multianalyte assay with algorithmic analysis, or MAAA test, that does not have a specific Category I code or an administrative code in Appendix O.	2	10	360	$90	$275.4K
81243	The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal…	7	30	210	$10	$255.3K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Quest Diagnostics Incorporated	NJ	Clinical Medical Laboratory	$111.2M	$637.7M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$60.5M	$289.1M
Laboratory Corporation Of America	AZ	Clinical Medical Laboratory	$38.5M	$265.9M

Billiontoone Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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