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NPI 1730466590 · San Diego, CA · Clinical Medical Laboratory
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Precision Toxicology, LLC is a clinical medical laboratory provider located in San Diego, California. This profile covers 5 Medicare and 48 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 | Precision Toxicology, LLC |
| Address | 4215 Sorrento Valley Blvd Ste 100 |
| City | San Diego |
| State | CA |
| ZIP | 92121 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 8, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $213.8M |
| Medicare | $13.8M |
PRECISION TOXICOLOGY, LLC’s code mix is strongly specialized in definitive and presumptive drug testing: its top Medicare and Medicaid activity is concentrated in definitive toxicology codes G0483, G0482, and G0481 plus the presumptive screen 80307. The descriptions and claim volumes (for example Medicare G0482 25.6K claims and Medicaid 80307 914.5K claims) indicate a centralized clinical toxicology laboratory model that performs high-volume confirmatory GC/MS- or LC/MS-based testing alongside mass presumptive screening.
Medicare revenue is highly concentrated in a few definitive testing codes: the provider’s top 3 Medicare codes account for 89.0% of its Medicare revenue, driven by G0483 ($6M, 43.1% of the provider's Medicare revenue; ranks #4 of 1063 nationally, 100th percentile; extreme outlier), G0482 ($5M, 36.0%; ranks #3 of 1618 nationally, 100th percentile; extreme outlier), and G0481 ($1.4M, 9.9%; ranks #5 of 1766 nationally, 100th percentile; extreme outlier). This concentration shows Medicare revenue depends on a narrow set of high-complexity definitive tests.
Medicaid billing is also concentrated but spread slightly more across definitive and screening tests: the top 3 Medicaid codes account for 66.4% of Medicaid revenue, primarily G0483 ($58M, 27.7% of the provider's Medicaid revenue; ranks #2 of 99 in-state, 99th percentile; extreme outlier), G0482 ($47.9M, 22.9%; ranks #2 of 56 in-state, 98th percentile; notably above typical state volume), and 80307 ($32.9M, 15.7%; ranks #2 of 660 in-state, 100th percentile; extreme outlier). This pattern indicates the business relies heavily on state Medicaid volumes to generate the majority of its revenue.
The provider’s payer mix is heavily skewed toward Medicaid in scale: lifetime Medicaid revenue is $213.8M versus total Medicare revenue of $13.8M, indicating the organization operates effectively as a Medicaid-focused testing vendor with Medicare representing a much smaller revenue stream. Given the absolute dollar gap ($213.8M vs $13.8M), strategic or contractual relationships with Medicaid programs likely drive the facility’s growth and utilization.
PRECISION TOXICOLOGY is a market leader on both national and in-state competitive metrics for its top codes: multiple Medicare rankings are in the top percentiles nationally (e.g., G0482 and G0483 at the 100th percentile, labeled extreme outlier compared with national peers), and many Medicaid code ranks are #2 in-state at the 98th–100th percentiles or better (for example, G0483, G0482, 80307, and G0481 are all top in-state performers). The presence of one #1 in-state rank (80375 at 100th percentile) plus numerous #2 ranks underlines a dominant position in California’s Medicaid toxicology testing market.
Claim volumes imply very high throughput laboratory operations: Medicaid claim counts are very large (80307 914.5K claims, G0482 583.8K claims, G0483 508.6K claims) while Medicare volumes are smaller but still substantial for a single NPI (Medicare G0482 25.6K claims; G0483 24.7K claims). These volumes support an operational profile of continuous specimen processing and automated screening/confirmatory workflows rather than low-volume specialty testing.
Payment-rate patterns show material differences by payer that help explain revenue composition: average paid per claim on Medicare is higher for definitive tests (e.g., Medicare G0483 $241/claim, G0482 $194/claim, G0481 $153/claim) while Medicaid averages are lower per claim (e.g., Medicaid G0483 $114/claim, G0482 $82/claim, 80307 $36/claim). Combined with vastly larger Medicaid claim counts, the lower Medicaid unit price is offset by scale to produce much larger aggregate Medicaid revenue.
PRECISION TOXICOLOGY, LLC has an established tenure (NPI enumerated 2011-11-08 (~15 years ago)), and that longevity plus the concentrated, high-volume billing profile suggests mature contractual relationships with payers and likely investments in high-throughput confirmatory testing infrastructure. The sustained, outsized ranks and repeated “extreme outlier” and “notably above typical” labels across payers are consistent with a long-standing commercial lab scaling its Medicaid footprint over time.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 24,720 | $240 | $6M |
| 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… | 25,640 | $190 | $5M |
| 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… | 8,990 | $150 | $1.4M |
| 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. | 18,290 | $60 | $1.1M |
| 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… | 3,660 | $110 | $410.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
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.
48 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 508,630 | $110 | $58M |
| 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… | 583,760 | $80 | $47.9M |
| 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. | 914,450 | $40 | $32.9M |
| 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… | 356,860 | $90 | $31.8M |
| 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… | 254,070 | $50 | $13.7M |
| 80321 | The lab analyst detects and measures the alcohol biomarker in a patient specimen. Alcohol biomarkers are physiological indicators of the alcohol exposure or ingestion. In this test, the analyst tests… | 124,760 | $20 | $1.9M |
| 80361 | The lab analyst measures the amount of or detects the presence of one or more opiates, narcotic analgesics that depress the central nervous system, in the specimen. | 157,850 | $10 | $1.6M |
| 80354 | The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen. | 152,310 | $10 | $1.5M |
| 80356 | The lab analyst measures the amount of or detects the presence of heroin metabolite in the patient specimen. | 148,640 | $10 | $1.5M |
| 80346 | The lab analyst measures the amount of or detects the presence of one to twelve benzodiazepines, which are tranquilizers, in a patient specimen. | 146,890 | $10 | $1.5M |
Showing 1–10 of 48
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
48 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2 | 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… | 2 | 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… | 2 | 70 | 650 | $70 | $1.6M |
| 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. | 2 | 660 | 1,490 | $30 | $417.2K |
| 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… | 2 | 340 | 970 | $40 | $343.6K |
| 80363 | The lab analyst measures the amount of or detects the presence of three or four opioids and opiate analogs, narcotic analgesics that depress the central nervous system, in the specimen. | 2 | 10 | 100 | $1 | $342.6K |
| 80323 | The lab analyst identifies and evaluates the level of alkaloid drugs in a patient specimen that are not specified elsewhere in CPT® by a different code from the class of alkaloids. | 2 | 10 | 440 | $10 | $328.2K |
| 80321 | The lab analyst detects and measures the alcohol biomarker in a patient specimen. Alcohol biomarkers are physiological indicators of the alcohol exposure or ingestion. In this test, the analyst tests… | 2 | 20 | 290 | $10 | $304.6K |
| 80356 | The lab analyst measures the amount of or detects the presence of heroin metabolite in the patient specimen. | 2 | 20 | 490 | $1 | $275.3K |
| 80343 | The lab analyst measures the amount of or detects the presence of four to six antipsychotics in a patient specimen. The antipsychotics the provider is testing for are not specified in other CPT®… | 2 | 10 | 8,090 | $10 | $265.8K |
Showing 1–10 of 48
Other providers in the same ZIP code as Precision Toxicology, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Veracyte Labs Sd Corporation | CA | Clinical Medical Laboratory | $75M | $2.4M |
| Sequenom Center For Molecular Medicine LLC | CA | Clinical Medical Laboratory | $0 | $74.1M |
| Biotheranostics, Inc. | CA | Clinical Medical Laboratory | $38.4M | $4M |
| H&m Molecular Diagnostics, LLC | CA | Clinical Medical Laboratory | $13.3M | $11.2M |
| Helix, Inc. | CA | Clinical Medical Laboratory | $169.2K | $22.6M |
| Scripps Health | CA | Clinical Medical Laboratory | $8.9M | $301.7K |
| Biocept, Inc. | CA | Clinical Medical Laboratory | $254.7K | $5.6M |
| Iain Macewan | CA | Radiation Oncology Physician | $2.2M | $0 |
| Prometheus Laboratories Inc. | CA | Clinical Medical Laboratory | $338.8K | $1.6M |
| Neogenomics Laboratories Inc | CA | Clinical Medical Laboratory | $1.8M | $0 |
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