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NPI 1659352276 · San Diego, CA · Clinical Medical Laboratory
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Laboratory Corporation Of America is a clinical medical laboratory provider located in San Diego, California. This profile covers 536 Medicare and 647 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 | 13112 Evening Creek Dr S |
| City | San Diego |
| State | CA |
| ZIP | 92128 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 10, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $147.2M |
| Medicare | $59.8M |
Medicaid is the dominant payer by scale for this NPI: reported lifetime Medicaid revenue is $147.2M versus total Medicare revenue of $59.8M, indicating the provider's billing volume and revenue are concentrated more heavily in Medicaid. The difference in scale suggests operational emphasis on Medicaid contracts and workflows that accommodate high-volume state program billing.
Revenue concentration is meaningful for both payers: the top three Medicare codes account for 34.6% of Medicare revenue and the top three Medicaid codes account for 35.0% of Medicaid revenue. For Medicare, the highest-revenue CPTs include 80053, 36415, and 80061 as primary drivers; for Medicaid, U0003, 87591, and 80061 are the top revenue contributors, signaling that a small set of tests drives a large share of each payer book.
Service-line mix indicates a broad reference-laboratory footprint that combines routine chemistry/hematology, specimen collection, and high-volume infectious disease molecular testing. Medicare high-revenue lines such as 80053 (CMP), 80061 (lipid panel), 85025 (CBC) and 36415 (venipuncture) plus Medicaid dominance on U0003 (SARS‑CoV‑2 PCR) and large-volume STI tests 87591 and 87491 point to an operation that handles both high-throughput routine panels and large-scale molecular diagnostics.
The provider’s Medicare coding volumes place it as a national-volume leader for many common assays: numerous Medicare codes (for example 80053, 36415, 80061, 84443, 82306, 85025) are listed as "extreme outlier" and ranked in the 100th percentile nationally, indicating volumes far above typical peers for those tests. This profile is consistent with a major centralized testing hub that processes very high specimen counts on routine assays.
On Medicaid in-state competition the provider also shows dominant volumes for key public-health and high-throughput testing lines: U0003 (COVID PCR) is $20.2M and ranked #4 of 751 in-state (100th percentile; extreme outlier), and multiple high-volume STI and screening codes (87591, 87491, 87389, 86592) are ranked at or near the top of statewide peers. These ranks and the labels "extreme outlier" and "notably above typical" reflect market leadership within the state for infectious disease and screening panels.
The mix includes higher-priced, specialty assays in addition to routine testing, which diversifies revenue beyond low-paid high-volume panels. Examples include Medicare code 81490 with avg paid/claim $824 and $601.5K revenue (1.5% of Medicare revenue, ranked as a typical volume among a small national cohort) and Medicaid code 81420 with avg paid/claim $155 and $4.4M revenue (4.2% of Medicaid revenue, 77th percentile), demonstrating the lab offers algorithmic/genomic and obstetric cell‑free DNA services alongside standard panels.
Operational scale is evident from massive claim counts reported across both payers: Medicare items such as 36415 at 591.7K claims and 80053 at 498K claims, together with Medicaid items like 80061 at 3.8M claims and U0003 at 698K claims, imply extensive specimen-collection networks, high-throughput instrumentation, and logistics to process large daily volumes. These claim volumes support the interpretation of a centralized reference lab with substantial throughput and distribution capacity.
The provider is long-established at this NPI: enumerated 2005-11-10 (~21 years ago). Combined with national and in-state extreme-outlier ranks across many routine and molecular codes, the tenure and volume profile are consistent with a mature, high-capacity laboratory operation that has built scale over two decades.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
536 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. | 498,000 | $10 | $5M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 591,730 | $10 | $4.7M |
| 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. | 347,370 | $10 | $4.5M |
| 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… | 267,720 | $20 | $4.3M |
| 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… | 121,040 | $30 | $3.5M |
| 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… | 417,290 | $10 | $3.3M |
| 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).… | 258,400 | $10 | $2.6M |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 77,090 | $20 | $1.4M |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 82,020 | $20 | $1.2M |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 30,220 | $40 | $1.2M |
Showing 1–10 of 536
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 536 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
536 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 11 | 20 | 650 | $2,290 | $16.6M |
| 81490 | 2 | 10 | 5,780 | $820 | $4.8M |
| 81450 | 3 | 10 | 60 | $740 | $679.4K |
| G0482 | 27 | 30 | 70 | $190 | $555.9K |
| 87999 | 4 | 10 | 1,450 | $290 | $436.6K |
| G0483 | 49 | 70 | 360 | $240 | $427.9K |
| 87798 | 81 | 110 | 1,340 | $30 | $338.2K |
| U0003 | 31 | 130 | 730 | $70 | $246.4K |
| 87150 | 27 | 30 | 1,690 | $30 | $222.6K |
| 83789 | 2 | 10 | 630 | $20 | $165K |
Showing 1–10 of 536
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.
647 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 697,950 | $30 | $20.2M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 1,523,260 | $10 | $9.1M |
| 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. | 3,751,400 | $1 | $7.5M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 1,482,240 | $10 | $7.4M |
| 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… | 3,346,150 | $1 | $6.7M |
| 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… | 2,025,990 | $1 | $6.1M |
| 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. | 4,672,210 | $1 | $4.7M |
| 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… | 4,591,740 | $1 | $4.6M |
| 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,… | 28,630 | $160 | $4.4M |
| 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… | 83,410 | $50 | $4.4M |
Showing 1–10 of 647
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
647 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,… | 8 | 30 | 300 | $260 | $18M |
| S5102 | Day care services, adult; per diem | 343 | 350 | 108,330 | $70 | $9.4M |
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 6 | 10 | 440 | $500 | $5.3M |
| G0482 | 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… | 24 | 60 | 370 | $80 | $4.1M |
| G0483 | 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… | 6 | 100 | 520 | $120 | $2.4M |
| 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. | 6 | 10 | 900 | $30 | $1.9M |
| G0481 | 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… | 6 | 70 | 650 | $70 | $1.6M |
| 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… | 6 | 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… | 6 | 10 | 3,270 | $60 | $1.5M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 17 | 50 | 500 | $160 | $1.1M |
Showing 1–10 of 647
Other providers in the same ZIP code as Laboratory Corporation Of America, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Laboratory Corporation Of America | CA | Clinical Medical Laboratory | $1.1M | $11.4M |
| Phamatech Incorporated | CA | Clinical Medical Laboratory | $812.9K | $3.2M |
| Scripps Health | CA | Ambulatory Surgical Clinic/Center | $1.5M | $0 |
| Scripps Clinic Medical Laboratories | CA | Clinical Medical Laboratory | $414.6K | $490 |
| Anil Patel | CA | Cardiovascular Disease Physician | $279.9K | $0 |
| Namee Kim | CA | Cardiovascular Disease Physician | $274K | $0 |
| Malhar Patel | CA | Cardiovascular Disease Physician | $242.4K | $0 |
| Ryan Frederiksen | CA | Diagnostic Radiology Physician | $210.5K | $1.6K |
| David Lee | CA | Diagnostic Radiology Physician | $141K | $0 |
| Tyler Adamson | CA | Sports Medicine (Family Medicine) Physician | $129.2K | $0 |
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