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NPI 1649767948 · Spokane, WA · Clinical Medical Laboratory
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Laboratory Corporation Of America is a clinical medical laboratory provider located in Spokane, Washington. This profile covers 252 Medicare and 171 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 | Laboratory Corporation Of America |
| Address | 110 W Cliff Dr Ste 100-200 |
| City | Spokane |
| State | WA |
| ZIP | 99204 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 23, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.1M |
| Medicare | $1.6M |
LABORATORY CORPORATION OF AMERICA in Spokane is an established clinical medical laboratory with an NPI enumerated on 2018-04-23 (~8 years ago), indicating roughly eight years of Medicare/Medicaid billing activity under this registration. The code mix across both payers (routine panels, endocrine assays, serologies, molecular/cytogenetic tests) aligns with a full‑service reference lab rather than a narrow point‑of‑care operation.
Medicaid is the larger payer for this billing entity: total Medicaid revenue is $6.1M compared with total Medicare revenue of $1.6M, so Medicaid accounts for the majority of reported public‑payer revenue on file. This means state contracts or high Medicaid testing volume are the primary revenue drivers rather than Medicare fee‑for‑service volumes.
Revenue concentration is moderate for both payers: the top 3 Medicare codes account for 29.7% of this provider's total Medicare revenue, while the top 3 Medicaid codes account for 26.4% of this provider's total Medicaid revenue. Those precomputed shares show that a handful of codes drive a meaningful share of each payer’s revenue but do not indicate single‑code dependency.
On Medicare the single largest code is 80053 (CMP): 16.7K claims, $10 avg paid/claim, $167K revenue (17.2% of this provider's total Medicare revenue) and it ranks #148 of 26416 providers nationally (99th percentile). Several other common clinical assays on Medicare — for example 84443 (TSH) and 86235 (ENA) — also sit near high national percentiles (84443: #255 of 19722, 99th percentile; 86235: #63 of 746, 92th percentile), which together suggest strong national activity on routine and specialized serologic testing.
On Medicaid the top revenue code is 86235 (ENA): 5.7K claims, $77 avg paid/claim, $439.5K revenue (11.1% of this provider's total Medicaid revenue) and it ranks #4 of 20 providers in‑state (84th percentile). The Medicaid top‑3 (86235, 80050, 87536) collectively make up 26.4% of the provider's Medicaid revenue, indicating a mix of specialty serology, broad screening panels, and infectious disease viral load testing driving a substantial portion of state revenue.
The provider shows several clear in‑state outlier signals on Medicaid: 83655 (lead testing) is an "extreme outlier" at 26.1K claims, $234.5K revenue and ranks #2 of 88 providers in‑state (99th percentile), and 87338 (H. pylori antigen) is an "extreme outlier" at 20.5K claims, $205.5K revenue and ranks #1 of 21 providers in‑state (100th percentile). These extreme outlier volumes for specific public‑health‑relevant assays imply either lab specialization in those tests or significant Medicaid testing contracts for childhood lead screening and GI pathogen workups.
Although many Medicare code ranks are in very high national percentiles (for example 80053 and 84443 both at the 99th percentile), the dataset annotates those volumes as "typical, unremarkable volume for this code," which suggests the provider achieves high absolute volume for common assays rather than operating a narrowly specialized high‑cost service line. At the same time, Medicare includes specialized cytogenetics/molecular codes (88275, 88271, 81479) with strong rank positions within their smaller national provider sets, indicating capability in higher‑complexity testing alongside large volumes of routine diagnostics.
Service‑line implications from the detailed code mix: routine chemistry and hematology panels (80053, 80061, 85025) form a backbone of billings, endocrine and reproductive hormone testing (84443, 84403, 84402, 82670) are significant, and both autoimmune/infectious serologies (86235, 87389, 86780, 86038) and higher‑complexity cytogenetics/molecular tests (88275, 88271, ) are represented. This diversity supports a full‑spectrum reference lab business model that serves primary care screening, specialty rheumatology/oncology monitoring, public‑health screening, and molecular diagnostic needs across payers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
252 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 16,700 | $10 | $167K |
| 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… | 4,040 | $20 | $64.6K |
| 86235 | The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,… | 3,290 | $20 | $55.9K |
| 83521 | The lab analyst performs a chemistry test to measure the level of each immunoglobulin light chain, kappa or lambda, in a serum specimen. A common lab method for this test is turbidimetry, which uses… | 3,050 | $20 | $51.8K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 980 | $50 | $49K |
| 82784 | The lab analyst performs the technical lab test to analyze the concentration of a particular gamma globulin in the specimen. The analyst may test for immunoglobulin A, immunoglobulin D,… | 4,890 | $10 | $44K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 310 | $140 | $43K |
| 83993 | The lab analyst performs the technical lab test on a small amount of stool sample to measure the amount of calprotectin, typically using an enzyme linked immunosorbent assay, or ELISA, test… | 2,020 | $20 | $38.4K |
| 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… | 4,680 | $10 | $37.5K |
| 88264 | The analyst performs a chromosome analysis and analyzes 20 to 25 cells. The analysis includes counting the number of chromosomes in each cell and preparing a karyotype for each cell examined. | 260 | $140 | $37.2K |
Showing 1–10 of 252
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 252 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
252 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 5 | 10 | 90 | $5,800 | $3.7M |
| 83521 | 2 | 10 | 1,460 | $20 | $44.4K |
| 86480 | 3 | 10 | 80 | $60 | $39.5K |
| 84402 | 3 | 10 | 760 | $20 | $37.5K |
| 86235 | 2 | 10 | 260 | $20 | $27.1K |
| 83880 | 11 | 30 | 60 | $40 | $22.7K |
| 82172 | 3 | 10 | 740 | $20 | $22.7K |
| 83921 | 3 | 10 | 1,320 | $20 | $21.9K |
| 80307 | 108 | 110 | 110 | $60 | $20.5K |
| 84403 | 3 | 20 | 70 | $30 | $20.5K |
Showing 1–10 of 252
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.
171 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 86235 | The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,… | 5,710 | $80 | $439.5K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 9,880 | $30 | $325.9K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 4,360 | $60 | $279.2K |
| 83655 | The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure. | 26,060 | $10 | $234.5K |
| 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. | 30,730 | $10 | $215.1K |
| 87338 | The lab analyst performs a test on a stool specimen to detect antigens of Helicobacter pylori bacteria using an immunoassay technique, such as EIA. | 20,550 | $10 | $205.5K |
| 83516 | The lab analyst performs the technical immunoassay test involving several steps to detect and measure an analyte of a noninfectious nature. The results show as positive or negative, or in… | 11,510 | $20 | $195.7K |
| 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… | 12,110 | $20 | $193.8K |
| 87209 | The lab analyst performs and evaluates a complex special stain from a primary source specimen, such as stool, to look for parasite eggs, or ova, and parasites, which are organisms that live in or on… | 12,010 | $10 | $168.2K |
| 86780 | The lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to Treponema pallidum, a spiral shaped bacteria called a spirochete, that causes syphilis. | 16,870 | $10 | $151.8K |
Showing 1–10 of 171
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
171 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 4 | 10 | 1,490 | $50 | $707.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 38 | 120 | 2,040 | $30 | $464.9K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 38 | 120 | 2,020 | $30 | $441.1K |
| 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… | 29 | 30 | 400 | $20 | $316.8K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 33 | 40 | 1,420 | $30 | $292.9K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 8 | 90 | 1,030 | $30 | $246.3K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 44 | 60 | 1,340 | $30 | $208.1K |
| 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. | 43 | 240 | 2,430 | $10 | $194.2K |
| 83013 | The lab analyst tests multiple breath samples for the presence of an isotope that indicates the presence of the H. pylori bacteria. This organism can cause irritation and ulcers of the stomach lining. | 9 | 20 | 130 | $50 | $174.2K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 4 | 20 | 330 | $50 | $166.3K |
Showing 1–10 of 171
Other providers in the same ZIP code as Laboratory Corporation Of America, ranked by combined Medicare and Medicaid revenue.
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