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NPI 1740705482 · Albuquerque, NM · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Albuquerque, New Mexico. This profile covers 88 Medicare and 81 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 | Quest Diagnostics Clinical Laboratories Inc |
| Address | 5601 Office Blvd Ne |
| City | Albuquerque |
| State | NM |
| ZIP | 87109 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 3, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.1M |
| Medicare | $832.7K |
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC in Albuquerque is operating as a clinical medical laboratory with a code mix dominated by routine chemistry and hematology panels and thyroid testing, indicating a high-throughput reference lab model. Medicare top codes 80053 (CMP), 84443 (TSH), and 80061 (lipid panel) together account for 50.0% of its Medicare revenue, and the Medicaid top codes show a similar focus (80050, 80061, 82306), which supports an operation centered on common outpatient diagnostic testing rather than highly specialized procedures.
Revenue concentration on Medicare is notable: the precomputed top-3 Medicare codes account for 50.0% of Medicare revenue, showing a heavy reliance on a small set of high-volume routine tests (80053, 84443, 80061). On the Medicaid side the top-3 codes account for 29.8% of Medicaid revenue, indicating a somewhat more diversified payer mix for state-covered patients where a broader set of tests contributes meaningfully to revenue.
In absolute payer scale this lab reports $832.7K in lifetime Medicare revenue versus $1.1M in lifetime Medicaid revenue, so Medicaid is the larger single-payer source of billed revenue for this location. That suggests this site performs materially for New Mexico Medicaid and that state contracts/relationships or local referral patterns contribute more to its volume than Medicare.
Competitive standing versus peers is mixed: for Medicare volume the provider ranks in very high national percentiles on several of its top tests (for example 80053 ranks in the 99th percentile nationally and 84443 is also 99th percentile), which indicates the lab has unusually large national-level claim counts for common panels relative to most providers. For Medicaid in-state comparisons, 80050 ranks #5 of 33 (88th percentile) and several other high-revenue Medicaid codes sit in mid-to-high state percentiles, placing the provider as a meaningful in-state participant but not the clear dominant lab across all test types.
Procedure-level patterns show expected reference-labor behavior: high claim counts for specimen collection (36415), routine panels (80053/80061/80050), and endocrine tests (84443, 84439, 84481) indicate processing of large outpatient phlebotomy volumes and centralized assay workups rather than inpatient-only services. The prominence of specific infectious disease and molecular tests in Medicaid (e.g., 87389 HIV screening, 87491/87591 NAAT for chlamydia and gonorrhea) also suggests the lab supports public-health screening and ambulatory care ordering patterns.
Tenure and registration are established: the NPI was enumerated on 2017-08-03 (~9 years ago), indicating several years in the Medicare/Medicaid billing system sufficient to accumulate the reported lifetime revenue and claim counts. This tenure supports interpretation of the present code mix as a stabilized operating profile rather than short-term startup activity.
Across many CPT codes the dataset labels the provider’s volumes as “typical, unremarkable” or high-percentile but still characterized as typical volume — for example multiple codes (80053, 80061, 85025, 36415) are in the 95th–100th national percentiles yet described as typical volume. That pattern is consistent with a large regional/reference lab that processes routine tests at scale rather than a niche specialist producing statistically anomalous code mixes.
Operational risk/attention points for payers and analysts: because half of Medicare revenue is concentrated in three codes (precomputed 50.0%) and Medicaid shows nearly 30% concentration in its top three, contract negotiations, price changes, or shifts in ordering patterns for a small set of common panels could materially move site revenue. Analysts should monitor utilization trends for 80053, 84443, 80061 (Medicare) and 80050, 80061, 82306 (Medicaid) when modelling network capacity or forecasting lab payment exposure.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
88 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. | 13,830 | $10 | $138.3K |
| 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… | 7,820 | $20 | $125.1K |
| 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. | 9,230 | $10 | $120K |
| 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… | 9,770 | $10 | $78.2K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 9,040 | $10 | $72.3K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 1,380 | $20 | $20.6K |
| 84481 | The lab analyst performs a test to measure free T3 in patient blood. | 1,100 | $20 | $18.7K |
| 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… | 3,040 | $10 | $18.2K |
| 82728 | The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute… | 1,400 | $10 | $18.2K |
| 82043 | The lab analyst quantitates a timed or random urine specimen for the measurement of albumin. Random means the specimen collection may occur without respect to the time of day. This is a valuable… | 2,990 | $10 | $17.9K |
Showing 1–10 of 88
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 88 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
81 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 2,560 | $40 | $109.9K |
| 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. | 6,380 | $10 | $89.3K |
| 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… | 2,670 | $30 | $85.5K |
| 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. | 7,400 | $10 | $81.4K |
| 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… | 4,470 | $20 | $80.4K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 9,850 | $10 | $68.9K |
| 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).… | 5,220 | $10 | $57.4K |
| 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… | 5,620 | $10 | $50.6K |
| 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… | 1,460 | $30 | $37.8K |
| 84403 | The lab analyst performs a test to measure total testosterone, typically in patient serum. | 1,100 | $30 | $31.9K |
Showing 1–10 of 81
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico median
81 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 14 | 10 | 350 | $120 | $373.8K |
| 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. | 40 | 100 | 2,650 | $10 | $265.6K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 5 | 30 | 260 | $50 | $236.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 34 | 60 | 930 | $40 | $226.4K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 34 | 60 | 980 | $30 | $223.5K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 17 | 20 | 550 | $50 | $222.5K |
| 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… | 35 | 50 | 1,890 | $10 | $163.4K |
| 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… | 44 | 130 | 1,500 | $10 | $149.6K |
| 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… | 21 | 70 | 540 | $30 | $140.1K |
| 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… | 27 | 80 | 1,640 | $20 | $132.8K |
Showing 1–10 of 81
Other providers in the same ZIP code as Quest Diagnostics Clinical Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
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