Loading...
NPI 1760730436 · Meridian, ID · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Ada West Dermatopathology, LLC is a clinical medical laboratory provider located in Meridian, Idaho. This profile covers 9 Medicare and 1 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 | Ada West Dermatopathology, LLC |
| Address | 1618 Millenium Way |
| City | Meridian |
| State | ID |
| ZIP | 83642 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 28, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $565.2K |
| Medicaid | $78.5K |
ADA WEST DERMATOPATHOLOGY, LLC presents as a specialty clinical medical laboratory focused on surgical pathology and dermatopathology: Medicare billing is heavily dominated by surgical pathology code 88305 (7.7K claims, $383.1K revenue, 67.8% of Medicare revenue), and the presence of immunohistochemistry codes such as 88342 and 88344 plus intraoperative consultation codes 88331/88332 indicates routine processing of excised skin and tumor specimens and provision of frozen-section consultations. The code mix implies both routine anatomic pathology workload and capability for ancillary IHC testing and intraoperative support.
Revenue concentration on Medicare is pronounced: the top 3 Medicare codes account for 83.4% of total Medicare revenue, with 88305 alone contributing $383.1K (67.8% of Medicare revenue), followed by 88342 ($50.7K, 9.0%) and 88312 ($37.5K, 6.6%). This concentration indicates the lab’s financial performance is highly dependent on a small set of pathology services.
On Medicaid the provider is effectively single-code: total Medicaid revenue is $78.5K while 88305 on Medicaid shows 1.7K claims and $78.9K revenue and is listed as 100.0% of this provider’s Medicaid revenue, indicating Medicaid billing is almost entirely for the same surgical pathology service driving Medicare income. That pattern suggests limited Medicaid diversification and operational focus on the same service line for both payers.
Payer mix is Medicare-dominant in scale: lifetime Medicare revenue is $565.2K versus lifetime Medicaid revenue of $78.5K, so Medicare comprises the clear majority of reported public-payer revenue. Analysts should therefore treat Medicare performance and coding patterns as the primary driver of this entity’s financial profile.
Competitive standing by code varies: for Medicare 88305 ranks #372 of 14580 providers nationally and is characterized as "notably above typical national volume," indicating the provider delivers unusually high volume for surgical pathology at a national level; 88331 (intraoperative consultation) ranks #50 of 4659 (99th percentile) and is labeled an "extreme outlier," signaling especially high national activity for frozen-section consultations. Other commonly billed Medicare codes such as 88342 (rank #425 of 11370, labeled "typical, unremarkable volume") and 88312 (rank #418 of 6966, labeled "typical, unremarkable volume") are less exceptional by the provided descriptors.
State-level competitiveness on Medicaid is modest: Medicaid 88305 ranks #16 of 33 providers in-state (53th percentile) and is described as "typical, unremarkable volume," indicating the provider holds a middle-tier share of in-state Medicaid surgical pathology activity rather than a dominant position. This contrasts with its stronger national standing on Medicare for the same code.
Operational implications from the code mix include a need for pathologist availability for both high-volume level IV surgical pathology interpretation (88305) and rapid intraoperative decision-making (88331/88332), as well as laboratory capacity for immunohistochemistry (88342, 88344) and special stains (88312). Payers and network planners should expect a workflow centered on processing excised specimens with ancillary testing and time-sensitive frozen sections, which influences referral relationships, turnaround expectations, and contracting considerations.
The provider has an established NPI tenure with enumeration on 2012-08-28 (~14 years ago), supporting a multi-year operational history in the market; longevity combined with the concentrated Medicare volumes suggests a stable specialty lab footprint focused on dermatopathology and related pathology services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 7,660 | $50 | $383.1K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 720 | $70 | $50.7K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 500 | $80 | $37.5K |
| 88331 | Pathological, or intraoperative, consultation provides necessary and precise information pertaining to diagnosis and prognosis which aid a surgeon in deciding whether to proceed further or not during… | 490 | $80 | $36.5K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 460 | $60 | $26.6K |
| 88332 | Pathology consultation during surgery provides necessary and precise information pertaining to diagnosis and prognosis that aids a surgeon in deciding whether to proceed further during surgery.… | 410 | $40 | $16.3K |
| 88344 | The lab analyst applies a single multiplex antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 50 | $120 | $5.9K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 160 | $30 | $4.8K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 60 | $50 | $3.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,680 | $50 | $78.9K |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 16 | 30 | 1,450 | $50 | $160K |
Other providers in the same ZIP code as Ada West Dermatopathology, LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.