Quest Diagnostics — Billing Profile & Reimbursement Data

Quest Diagnostics shows almost exclusively Medicare activity in the dataset: total Medicare revenue is $224.6K while there is no Medicaid billing on file, indicating an effectively single-payer footprint in these records and limited visibility into any state-payor business driven by Medicaid. The absence of Medicaid claims suggests this particular NPI/record either does not participate in Medicaid or that Medicaid billing is routed through other NPIs or corporate entities.

Revenue is concentrated in a small set of lab and phlebotomy services: the precomputed top-3 Medicare codes account for 34.6% of total Medicare revenue, highlighting that a minority of tests generate a disproportionate share of payments. The top individual code by Medicare revenue is 36415 (venipuncture) with $20.7K (11.9% of Medicare revenue), reflecting heavy throughput of specimen collection relative to other services.

The provider’s Medicare code mix is consistent with a high-volume diagnostic laboratory and outpatient phlebotomy operation: leading procedures include venipuncture (36415), TSH testing (84443), and lipid panel (80061), plus broad panels like CMP () and CBC (), which together indicate routine clinical lab testing and sample collection as core service lines rather than complex procedures or imaging. This mix suggests an operational model centered on processing standard blood tests and panels ordered by ambulatory clinicians.