Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Utah for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Utah only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Utah (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Lineagen, Inc. (NPI 1699095901)

Field	Value
Entity Type	Organization
Organization	Lineagen, Inc.
Address	2677 E Parleys Way
City	Salt Lake City
State	UT
ZIP	84109
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	June 9, 2010

Payer Source	Total Paid
Medicaid	$15.5M
Medicare	$0

Key Findings

LINEAGEN, INC. is effectively a Medicaid-focused laboratory with $15.5M in lifetime Medicaid revenue and no Medicare billing on file, making the provider functionally single-payer in the claims data available. Its NPI was enumerated on 2010-06-09 (~16 years ago), indicating an established presence in the market.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 97.5% of the provider’s total Medicaid revenue. The dominant code is 81229 (chromosomal microarray) at $12.7M (82.2% of Medicaid revenue), followed by 81415 (exome sequencing) at $1.7M (10.8%) and 81243 (FMR1/fragile X testing) at $702.5K (4.5%).

The code mix indicates a specialized genetic testing operation: heavy emphasis on high-resolution chromosomal microarray testing (81229) and clinical exome sequencing (81415), with additional targeted molecular testing for fragile X (81243). These procedure types and their revenue shares suggest the lab performs centralized, high-complexity genomic diagnostic services rather than routine clinical chemistry or anatomic pathology.

81229 is ranked #1 of 3 providers in-state and is at the 100th percentile in the state; the supplied descriptor characterizes the volume as "typical, unremarkable" for this code despite the top statewide rank. This implies LINEAGEN is the leading Medicaid biller for chromosomal microarray in Utah among the reported set, but that its build-out for this test aligns with expected service volume for a specialized lab.

Both 81415 and 81243 are reported as #1 of 1 providers in-state with a 0th percentile label and notes that no state peer volume comparison is available. Practically, LINEAGEN appears to be the sole reported Medicaid billing source in the state for exome sequencing (81415) and for fragile X testing (81243), which indicates a unique provider role for these services within the state Medicaid claims data.

Paid amounts per claim are materially different across the top codes, reflecting different test complexity and pricing: 81229 shows 12.9K claims at $987 avg paid/claim, 81415 shows 997 claims at $1684 avg paid/claim, and 81243 shows 10.5K claims at $67 avg paid/claim. This pattern—high-volume, mid-priced CMA and fragile X testing combined with lower-volume, higher-priced exome sequencing—suggests operational throughput focused on large-scale diagnostic screens plus more specialized, higher-reimbursement sequencing.

The extreme revenue concentration (97.5% from three genetic/test-specific codes) creates a business profile dependent on continued demand and Medicaid coverage for these genetic diagnostics. For payer or competitive analysis, this underscores the importance of monitoring reimbursement trends and referral pathways for 81229, 81415, and 81243, since shifts in coverage or utilization for these specific codes would materially impact LINEAGEN’s Medicaid revenue base.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
81229	The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by…	12,900	$990	$12.7M
81415	The lab analyst performs an exome gene sequence analysis to look for genetic changes that could account for an unexplained disorder or syndrome in the patient.	1,000	$1,680	$1.7M
81243	The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal…	10,490	$70	$702.5K
81416	The lab analyst performs an exome gene sequence analysis in a relative of the patient to create a reference exome gene sequence, which the lab analyst can compare to the patient’s exome to evaluate…	700	$470	$325K
81226	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6.	610	$40	$21.3K
81401	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 2 molecular pathology code.	610	$30	$18.8K
81225	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19.	610	$20	$14K
81227	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 9, also known as CYP2C9.	280	$10	$3.9K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.

Claims Volume vs. Utah Distribution

Lineagen, Inc. — 4 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81229	The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by…	1	10	20	$990	$4.2M
81415	The lab analyst performs an exome gene sequence analysis to look for genetic changes that could account for an unexplained disorder or syndrome in the patient.	1	10	1,000	$1,680	$1.7M
81243	The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal…	1	10	10,490	$70	$703.1K
81416	The lab analyst performs an exome gene sequence analysis in a relative of the patient to create a reference exome gene sequence, which the lab analyst can compare to the patient’s exome to evaluate…	1	10	700	$470	$324.9K
81401	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 2 molecular pathology code.	1	10	610	$30	$18.7K
81226	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6.	1	10	340	$30	$10.8K
81225	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19.	1	10	340	$20	$7.2K
81227	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 9, also known as CYP2C9.	1	10	180	$10	$1.9K

Nearby Providers

Other providers in the same ZIP code as Lineagen, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Project Connection Utah	UT	Mental Health Counselor	$0	$4.4M
Tyler Hanks	UT	Pediatric Dentistry	$0	$582.1K
Judd Cahoon	UT	Ophthalmology Physician	$348.7K	$0
Susan Edwards	UT	Family Medicine Physician	$111.8K	$0
James Peterson	UT	Obstetrics Physician	$57.5K	$1.7K
Marc Hyde	UT	Emergency Medicine Physician	$46.7K	$0
Associated Fresh Markets Inc	UT	Pharmacy	$43K	$0
Brad Wright	UT	Neuroradiology Physician	$25.9K	$0
Emma Crossett	UT	Physical Therapist	$22.1K	$0
Bernardo Fernandez	UT	Physician Assistant	$10.8K	$0

Lineagen, Inc. — Billing Profile & Reimbursement Data

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Lineagen, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References