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NPI 1639769953 · South Jordan, UT · Clinical Medical Laboratory
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Prime Labs LLC is a clinical medical laboratory provider located in South Jordan, Utah. This profile covers 67 Medicare and 40 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 | Prime Labs LLC |
| Address | 10619 S Jordan Gtwy Ste 125 |
| City | South Jordan |
| State | UT |
| ZIP | 84095 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 20, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $385.3K |
PRIME LABS LLC is operating primarily as a molecular and clinical diagnostic laboratory focused on amplified nucleic acid probe techniques and routine chemistry/hematology panels; its Medicare billing profile is dominated by molecular infectious‑disease assays (examples include 87798, 87481, 87640, 87651, 87641) alongside routine panels such as 80053 and 85025. The combined Medicare ($1.7M) and Medicaid ($385.3K) totals show the operation is mid-sized for a specialized lab rather than a large hospital reference lab.
Medicare revenue is highly concentrated: the top three Medicare CPT/HCPCS codes account for 65.1% of Medicare revenue, driven overwhelmingly by 87798 which alone generated $864.2K (52.9% of Medicare revenue). This concentration indicates PRIME LABS depends on a small set of amplified-probe molecular tests for most of its Medicare intake.
Medicaid revenue shows a similar concentration: the top three Medicaid codes account for 64.2% of Medicaid revenue, led by 87798 at $187.9K (49.6% of Medicaid revenue) and followed by U0003 and 87801. The Medicaid mix therefore mirrors Medicare in being dominated by amplified‑nucleic‑acid infectious‑disease testing, with COVID PCR (U0003) also representing a material share.
The payer mix is Medicare‑heavy in scale — reported Medicare revenue is $1.7M versus $385.3K in Medicaid — so commercial/Medicare relationships are likely more important to overall volume and revenue resilience than Medicaid. While the lab serves both payers, it is not effectively single‑payer and relies substantially more on Medicare.
Competitive standing for key molecular codes is mixed: on Medicare 87798 ranks #75 of 1319 providers nationally (94th percentile) and is described as "typical, unremarkable volume," indicating the lab is a solid national participant for a broad amplified‑probe test but not a dominant national leader. Conversely, 87651 on Medicare ranks #44 of 3530 (99th percentile) and is explicitly noted as "notably above typical national volume," marking at least one test where PRIME LABS performs at materially higher volume than most peers.
On Medicaid within Utah, PRIME LABS shows stronger local positioning on several codes: 87798 ranks #3 of 14 providers in-state (85th percentile) and U0003 ranks #7 of 24 (74th percentile), reflecting above‑median in‑state activity for those assays. The lab is the in‑state leader for 87541 (rank #1 of 3, 100th percentile), indicating selective dominance for that specific test (Legionella) even though overall Medicaid revenue is smaller.
Tenure is relatively short compared with many established labs: the NPI was enumerated on 2021-01-20 (~5 years ago), suggesting PRIME LABS grew into its current Medicare/Medicaid footprint within the past half‑decade. That recent enumeration combined with concentrated molecular volumes suggests targeted build‑out of molecular testing capacity after 2021.
Most non‑top codes across both payers are described as "typical, unremarkable volume," including many routine chemistry and collection codes (examples on Medicare include 80053, 85025, 36415). This pattern — one or two very large molecular revenue drivers and a long tail of routine tests at typical volumes — is consistent with a focused reference lab that provides both high‑throughput molecular assays and standard lab services to support ordering providers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
67 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… | 25,420 | $30 | $864.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 3,910 | $30 | $133K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 1,970 | $30 | $66.8K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 1,840 | $30 | $62.4K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 1,830 | $30 | $62.4K |
| 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. | 1,830 | $30 | $62.3K |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 1,830 | $30 | $62.1K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 1,750 | $30 | $59.4K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 1,750 | $30 | $59.4K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 26,920 | $1 | $26.9K |
Showing 1–10 of 67
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 67 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
67 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87798 | 1 | 10 | 480 | $30 | $226.9K |
| 87481 | 1 | 10 | 2,010 | $30 | $69.2K |
| U0003 | 3 | 10 | 390 | $70 | $46.3K |
| 87640 | 1 | 10 | 1,010 | $30 | $34.8K |
| P9603 | 2 | 10 | 30,890 | $1 | $33.6K |
| 87653 | 1 | 10 | 940 | $30 | $32.4K |
| 87500 | 1 | 10 | 940 | $30 | $32.3K |
| 87641 | 1 | 10 | 940 | $30 | $32.2K |
| 87491 | 1 | 10 | 890 | $30 | $30.5K |
| 87591 | 1 | 10 | 890 | $30 | $30.3K |
Showing 1–10 of 67
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
40 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… | 1,200 | $160 | $187.9K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high… | 1,210 | $30 | $38.7K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 500 | $30 | $16.6K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 500 | $30 | $13.6K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 270 | $50 | $13.1K |
| 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… | 1,800 | $10 | $12.6K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 770 | $10 | $10.8K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 1,160 | $10 | $10.4K |
| 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. | 1,640 | $10 | $9.8K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 360 | $20 | $7.6K |
Showing 1–10 of 40
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
40 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high… | 7 | 20 | 270 | $40 | $334.7K |
| 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… | 53 | 120 | 1,100 | $30 | $186.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 128 | 240 | 220 | $50 | $145.2K |
| 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… | 73 | 70 | 340 | $50 | $117.7K |
| 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… | 3 | 10 | 230 | $80 | $89K |
| 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. | 59 | 100 | 2,770 | $10 | $75.1K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 6 | 20 | 70 | $50 | $71K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 3 | 10 | 500 | $40 | $69.4K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 4 | 10 | 310 | $130 | $61K |
| 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… | 43 | 50 | 240 | $30 | $48.7K |
Showing 1–10 of 40
Other providers in the same ZIP code as Prime Labs LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Ihc Health Services Inc | UT | Home Infusion Therapy Pharmacy | $0 | $38.1M |
| Ihc Health Services Inc | UT | Durable Medical Equipment & Medical Supplies | $0 | $26.9M |
| Parenting Possibilities | UT | Behavior Analyst | $0 | $12.5M |
| Ihc Health Services Inc | UT | Home Health Agency | $0 | $9.6M |
| Ihc Health Services Inc | UT | Community Based Hospice Care Agency | $0 | $6.5M |
| Roselene Dalanhese | UT | Clinical Social Worker | $0 | $3M |
| Physician Group Of Utah Inc | UT | Specialist | $0 | $2.8M |
| See Healthcare, LLC | UT | Community Based Hospice Care Agency | $0 | $2.1M |
| City Of South Jordan | UT | Land Ambulance | $258K | $1.6M |
| South Point Counseling Services, LLC | UT | Clinical Social Worker | $0 | $1.8M |
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