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NPI 1700913118 · San Dimas, CA · Clinical Medical Laboratory
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Biological Laboratory, Inc. is a clinical medical laboratory provider located in San Dimas, California. This profile covers 192 Medicare and 217 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 | Biological Laboratory, Inc. |
| Address | 620 W. Covina Blvd |
| City | San Dimas |
| State | CA |
| ZIP | 91773 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 27, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $24.9M |
| Medicare | $19.4M |
BIOLOGICAL LABORATORY, INC. operates as a high-throughput clinical medical laboratory with a billing mix dominated by large-scale infectious disease diagnostics and routine clinical chemistry/hematology panels. The Medicare and Medicaid top codes include COVID-specific diagnostic codes (K1034, U0003, 87635, G2023) alongside high volumes of routine panels such as 80053, 85025 and hemoglobin fractionation 83021, indicating parallel workflows for mass public-health testing and standard ambulatory laboratory services.
Medicare revenue is highly concentrated: the provider’s top three Medicare codes account for 79.0% of its total Medicare revenue, with K1034 alone generating $13.6M (73.1% of Medicare revenue). This concentration shows the provider relies heavily on a single high-volume code for the majority of its Medicare receipts, while smaller contributions come from high-volume routine tests like 83021 ($454.4K) and 87635 ($440.5K).
Medicaid revenue is also concentrated but less so than Medicare: the top three Medicaid codes account for 58.9% of total Medicaid revenue, driven primarily by U0003 ($8.3M, 36.6% of Medicaid revenue) and large volumes of STI NAAT testing 87491 ($2.6M) and 87591 ($2.5M). The Medicaid mix suggests substantial state-level public-health and sexually-transmitted infection screening work alongside COVID testing.
Payer mix is tilted toward Medicaid in scale: lifetime Medicaid revenue of $24.9M exceeds Medicare revenue of $19.4M, so the provider is not single-payer reliant and generates a larger absolute payment volume from Medicaid. This distribution implies contracting and utilization dynamics will be meaningfully influenced by state Medicaid policies and public-health testing demand.
Competitive standing varies by code: the provider is a national outlier on several Medicare codes—K1034 ranks #37 of 30143 providers nationally (100th percentile; extreme outlier) and 83021 ranks #1 of 97 providers nationally (100th percentile; extreme outlier)—reflecting dominant volume for those specific services. In Medicaid, U0003 ranks #15 of 751 in-state (98th percentile) and both 87491 and 87591 sit in the high state percentiles (#19 of peers, 99th and 98th percentiles), which places the lab among the higher-volume in-state providers for infectious disease testing but not uniformly dominant across all panels.
Operational scale signals are substantial: the provider reported 1.1M claims for K1034 on Medicare and 143.3K Medicaid claims for U0003, and also records very large claim counts for routine tests (for example, Medicare 35.4K claims for 80053 and Medicaid 82.3K claims for 85025). High claim volumes for specimen-collection travel codes (Medicare P9603 with 161K claims and Medicare P9604 with 14.2K claims) further indicate a broad logistics footprint supporting specimen pickup and community collection.
The provider’s billing profile shows sensitivity to COVID-era testing codes: large revenue buckets tied to K1034 ($13.6M) and U0003 ($8.3M) plus notable Medicaid revenues for U0005 ($584.2K) and G2023 ($1.2M) imply material exposure to changes in testing demand and reimbursement for SARS‑CoV‑2 diagnostics. Analysts should treat COVID-related code utilization as a potential source of revenue volatility as public-health testing needs and payer policies evolve.
BIOLOGICAL LABORATORY, INC. has an established presence with NPI enumerated 2007-02-27 (~19 years ago) and a Clinical Medical Laboratory taxonomy, indicating long-tenured operations. That tenure combined with high-volume state and national rankings on select assays suggests the organization has built durable capacity in both routine laboratory services and community-scale infectious disease testing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
192 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,136,560 | $10 | $13.6M |
| 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… | 8,880 | $70 | $657K |
| 83021 | The lab analyst measures and calculates the hemoglobin fractions in a whole blood sample demonstrated by this hemoglobin fractionation test by chromatography. | 25,250 | $20 | $454.4K |
| 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… | 8,810 | $50 | $440.4K |
| 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. | 34,500 | $10 | $345K |
| 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… | 20,260 | $20 | $324.2K |
| 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… | 11,130 | $30 | $322.6K |
| 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 | 14,250 | $20 | $313.5K |
| 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. | 23,530 | $10 | $305.8K |
| 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… | 35,440 | $10 | $283.5K |
Showing 1–10 of 192
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 192 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
192 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87798 | 109 | 110 | 1,340 | $30 | $338.2K |
| U0003 | 10 | 130 | 730 | $70 | $246.4K |
| P9603 | 6 | 20 | 64,580 | $1 | $240.2K |
| G0480 | 16 | 50 | 70 | $110 | $119.4K |
| G2023 | 13 | 90 | 1,030 | $20 | $110.9K |
| 86235 | 40 | 60 | 1,220 | $20 | $75.7K |
| U0005 | 10 | 150 | 780 | $20 | $75.1K |
| 80307 | 12 | 150 | 220 | $60 | $69.2K |
| 83021 | 1 | 10 | 70 | $20 | $68.2K |
| K1034 | 4 | 2,780 | 710 | $10 | $58.8K |
Showing 1–10 of 192
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.
217 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… | 143,260 | $60 | $8.3M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 91,450 | $30 | $2.6M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 89,680 | $30 | $2.5M |
| 87806 | The lab analyst may conduct tests to identify the presence of HIV type 1 or type 2 strain in the patient’s blood. | 49,800 | $20 | $1.2M |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 64,350 | $20 | $1.2M |
| 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… | 45,940 | $20 | $872.8K |
| 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. | 23,580 | $40 | $848.7K |
| 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… | 25,860 | $30 | $672.2K |
| 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,… | 58,420 | $10 | $584.2K |
| 80055 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen, a rubella antibody, a qualitative non… | 12,000 | $30 | $383.9K |
Showing 1–10 of 217
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
217 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S5102 | Day care services, adult; per diem | 338 | 350 | 108,330 | $70 | $9.4M |
| 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… | 21 | 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… | 26 | 100 | 520 | $120 | $2.4M |
| 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… | 55 | 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… | 85 | 110 | 190 | $140 | $1.6M |
| 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… | 15 | 750 | 950 | $50 | $890K |
| 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. | 28 | 660 | 1,490 | $30 | $417.2K |
| 0202U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the… | 73 | 90 | 740 | $210 | $382.4K |
| 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… | 97 | 340 | 970 | $40 | $343.6K |
| 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… | 90 | 290 | 220 | $210 | $268.3K |
Showing 1–10 of 217
Other providers in the same ZIP code as Biological Laboratory, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Curative Labs Inc. | CA | Clinical Medical Laboratory | $0 | $87.4M |
| San Dimas Retirement Center LLC | CA | Assisted Living Facility | $0 | $29.6M |
| Sabah Kadhium | CA | Family Medicine Physician | $697.1K | $210.7K |
| Joshua Koh | CA | Psychiatry Physician | $537.1K | $53.2K |
| David Swearingen | CA | Optometrist | $381.9K | $1.9K |
| Thomas Delaney | CA | Clinical Psychologist | $274.4K | $93.4K |
| Mohsen Ali | CA | Neurology Physician | $336.5K | $0 |
| Mojtaba Moghadam | CA | Nephrology Physician | $325.9K | $1.7K |
| Ashley Nakamura | CA | Optometrist | $124.8K | $0 |
| Phuoc Nguyen | CA | Anesthesiology Physician | $78.5K | $1.1K |
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