Loading...
NPI 1659322360 · Brockton, MA · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
U S Lab & Radiology LLC is a clinical medical laboratory provider located in Brockton, Massachusetts. This profile covers 144 Medicare and 168 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 | U S Lab & Radiology LLC |
| Address | 2 Jonathan Dr |
| City | Brockton |
| State | MA |
| ZIP | 02301 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.7M |
| Medicare | $4.3M |
U S LAB & RADIOLOGY LLC operates clearly as a high-volume clinical medical laboratory with a heavy emphasis on specimen collection and routine diagnostic panels; its top billed services include travel allowances for home/nursing-home specimen collection (P9603/P9604), high-volume venipuncture (36415), and common lab panels like CBC (85025), BMP (80048) and CMP (80053). The mix of codes and their descriptions point to a business model built around broad community phlebotomy and processing of high-frequency chemistry and hematology tests rather than specialized reference testing.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes (P9603, 36415, 85025) account for 55.2% of the provider's Medicare revenue. Those top codes include a travel allowance and two high-volume phlebotomy/CBC items, which indicates a small set of service lines drive most Medicare payments.
Medicaid revenue is also concentrated but less so than Medicare: the precomputed top-3 Medicaid codes (P9604, 85025, 80048) account for 40.7% of the provider's Medicaid revenue. On the Medicaid side P9604 is a top driver with 414.4K claims and $1.2M revenue, showing the same operational emphasis on homebound/nursing home specimen collection paired with high volumes of CBC and BMP testing.
Payer mix tilts toward Medicaid in scale: lifetime Medicaid revenue is $6.7M compared with $4.3M in Medicare, so Medicaid represents the larger single source of reimbursement for this entity. This is not a single-payer operation; significant volumes and revenue come from both payers, but Medicaid is the larger contributor by the reported totals.
Nationally for Medicare items this provider ranks as a high-volume outlier on several core codes: 36415 ranks #44 of 86467 (100th percentile; extreme outlier), 85025 ranks #70 of 32833 (100th percentile; extreme outlier), and P9603 ranks #14 of 267 (95th percentile; notably above typical national volume). Those rank/percentile placements characterize the provider as a major national outlier in routine phlebotomy and related specimen-collection billing rather than a modest participant.
Within Massachusetts Medicaid data the provider is a dominant state-level operator for travel/collection and several lab tests: P9604 ranks #1 of 27 in-state (100th percentile; extreme outlier) and other codes such as ATP08, 85610, 80164 and 80202 also show #1 rankings in-state (100th percentile for each). These state-first ranks indicate market leadership in homebound specimen collection and selected assay volumes compared with in-state peers.
The dataset flags multiple statistical outlier labels that reinforce an operational profile: codes described as “extreme outlier” or “notably above typical” appear across both payers for specimen collection (P9603/P9604) and routine tests (36415, 85025, 80048), signaling unusually high per-provider volumes rather than atypical unit payments. From a business-operations perspective, this pattern suggests concentrated throughput in repeatable, low-cost tests and extensive specimen-collection activity, which may make revenue sensitive to any payer policy changes targeting travel/collection codes or high-frequency venipuncture billing.
The provider has longevity in the market, with NPI enumeration dated 2006-05-15 (~20 years ago), consistent with an established operation capable of building the referral and collection infrastructure reflected in the high claim volumes and top-state/national rankings. Tenure combined with the billing footprint supports the view of a mature, high-capacity clinical laboratory focused on community and home/nursing-home specimen collection.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
144 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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 | 1,008,710 | $1 | $1M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 96,340 | $10 | $770.7K |
| 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… | 43,410 | $10 | $347.2K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 33,020 | $10 | $264.1K |
| 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. | 25,290 | $10 | $252.9K |
| 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… | 11,980 | $20 | $191.7K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 7,480 | $10 | $97.3K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 9,670 | $10 | $96.7K |
| 87088 | The lab analyst or microbiologist observes a urine culture with an unknown organism or organisms and makes a presumptive identification of each organism that needs identification. | 11,920 | $10 | $95.3K |
| 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… | 2,990 | $30 | $86.6K |
Showing 1–10 of 144
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 144 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
144 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| P9603 | 1 | 10 | 38,630 | $1 | $294.6K |
| 87088 | 3 | 10 | 7,290 | $10 | $123.3K |
| 83921 | 6 | 10 | 1,280 | $20 | $122.5K |
| 86480 | 3 | 10 | 2,550 | $60 | $109.2K |
| 87798 | 50 | 50 | 1,130 | $30 | $61.7K |
| P9604 | 3 | 10 | 5,270 | $10 | $44.4K |
| 80197 | 3 | 10 | 130 | $10 | $33.6K |
| 87536 | 6 | 10 | 50 | $80 | $28.1K |
| 87522 | 4 | 10 | 470 | $40 | $21.9K |
| 86141 | 5 | 20 | 60 | $10 | $20.2K |
Showing 1–10 of 144
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.
168 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 414,420 | $1 | $1.2M |
| 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… | 301,960 | $1 | $603.9K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 228,800 | $1 | $457.6K |
| 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. | 170,210 | $1 | $340.4K |
| 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… | 72,910 | $1 | $291.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 237,570 | $1 | $237.6K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 78,830 | $1 | $236.5K |
| 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… | 26,100 | $10 | $234.9K |
| 85027 | The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the… | 82,190 | $1 | $164.4K |
| ATP14 | N/A | 79,810 | $1 | $159.6K |
Showing 1–10 of 168
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
168 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… | 55 | 130 | 1,830 | $60 | $974.3K |
| 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… | 19 | 30 | 270 | $290 | $731.4K |
| 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. | 127 | 370 | 500 | $40 | $605.1K |
| 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… | 11 | 30 | 1,140 | $60 | $598K |
| G0480 | 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… | 105 | 200 | 450 | $30 | $511.5K |
| 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,… | 16 | 50 | 520 | $90 | $222.1K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 22 | 30 | 2,040 | $40 | $199.2K |
| 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… | 19 | 160 | 570 | $10 | $167.2K |
| 0241U | N/A | 80 | 90 | 350 | $60 | $158.8K |
| U0005 | 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, cdc or non-cdc,… | 71 | 100 | 1,930 | $20 | $155.5K |
Showing 1–10 of 168
Other providers in the same ZIP code as U S Lab & Radiology LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.