Loading...
NPI 1770207607 · Tulsa, OK · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Vanguard Laboratory Innovations is a clinical medical laboratory provider located in Tulsa, Oklahoma. This profile covers 104 Medicare and 73 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 | Vanguard Laboratory Innovations |
| Address | 8640 S Peoria Ave |
| City | Tulsa |
| State | OK |
| ZIP | 74132 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 4, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.4M |
| Medicaid | $62.5K |
This entity is Medicare‑focused in scale: reported Total Medicare revenue is $2.4M versus Total Medicaid revenue of $62.5K, indicating Medicare drives the vast majority of billed revenue while Medicaid is a very small share of overall activity. The provider’s NPI was enumerated on 2022-10-04 (~4 years ago), so this is a relatively recent entrant to fee‑for‑service billing patterns.
Service mix centers on high‑complexity genomic testing plus ancillary infectious disease nucleic‑acid testing: Medicare top codes are dominated by genomic panels 81419 ($806.4K, 37.0%) and 81430 ($476.3K, 21.9%), both sequence‑based gene panels, alongside broad amplified‑probe infectious testing such as 87798 (3.3K claims, $111.8K, 5.1%). This code mix suggests the lab operates as a specialized molecular/genomic sequencing provider that also processes large volumes of lower‑paid NAAT and multiplex infectious panels.
Medicare revenue is highly concentrated in a few high‑value genomics codes: the precomputed top‑3 Medicare codes account for 64.0% of this provider’s total Medicare revenue, led by 81419 and 81430. That concentration indicates business risk and specialization tied to a small number of complex tests rather than a broad distribution of moderate‑value services.
On Medicare competitive standing, the provider is a national leader for at least one specialized panel: 81430 ranks #1 of 8 providers nationally (100th percentile; notably above typical national volume) and therefore represents a standout line of business. By contrast, 81419 ranks #5 of 27 (85th percentile; typical, unremarkable volume), indicating above‑median but not dominant national positioning for that particular epilepsy gene panel.
The provider also posts metrics that reflect high claim volume but low per‑claim payments in infectious testing: for example, 87798 shows 3.3K Medicare claims with $34 avg paid/claim and $111.8K revenue, and 87481 shows 563 Medicare claims with $34 avg paid/claim and $19.1K revenue. This pattern—many low‑paid infectious tests alongside fewer, high‑paid genomic panels—points to an operational model combining high‑throughput screening/NAAT work with targeted high‑complexity sequencing.
Medicaid billing is even more concentrated than Medicare: the precomputed top‑3 Medicaid codes account for 80.8% of this provider’s Medicaid revenue, with 87637 ($26.1K, 44.4%), 81419 ($16K, 27.2%), and 87798 ($5.4K, 9.3%) collectively driving most Medicaid receipts. Given the small absolute dollar amount ($62.5K total Medicaid revenue), these Medicaid volumes appear operationally secondary to the firm’s Medicare business.
State‑level comparisons show mixed presence: for Medicaid, 81419 is listed as #1 of 1 providers in‑state (0th percentile; no state peer volume comparison available) and 81185 is also #1 of 1 providers in‑state (0th percentile; no state peer volume comparison available), which suggests limited in‑state peer reporting for certain specialty sequencing codes and complicates competitive interpretation. More routine Medicaid targets such as 87637 rank mid‑pack (12 of 26; 56th percentile) and therefore represent typical in‑state activity rather than dominance.
Several codes are flagged as "notably above typical national volume" despite modest absolute dollars, which is important for payer negotiations and network strategy: 81430 (Medicare) is notably above typical national volume and 81254 (Medicare) ranks #1 of 12 (100th percentile; notably above typical national volume) even though 81254 contributes only $10.1K to Medicare revenue. These high‑percentile placements on niche panels indicate pockets of outsized specialty volume that could influence pricing leverage or referral sourcing despite the overall small business footprint.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
104 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81419 | The lab analyst performs the technical lab test on a specimen such as blood to conduct a genomic sequence analysis panel. The test evaluates the genetic sequences of at least the 24 genes listed in… | 340 | $2,400 | $806.4K |
| 81430 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 60 genes, including 16 genes that the code descriptor lists, which may… | 300 | $1,590 | $476.3K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 3,290 | $30 | $111.8K |
| 81302 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the methyl CpG binding protein 2, or MECP2 gene. | 210 | $520 | $108.1K |
| 81223 | The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR. | 170 | $490 | $80.2K |
| 81238 | The lab analyst performs the technical lab test to analyze the full gene sequence of the coagulation factor IX (F9) gene. | 140 | $590 | $79.4K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 500 | $140 | $69.4K |
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 70 | $830 | $58.7K |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 80 | $590 | $48.8K |
| 81333 | The lab analyst performs the technical lab test to detect the presence of common changes in the transforming growth factor beta–induced gene (TGFBI). | 340 | $130 | $45.7K |
Showing 1–10 of 104
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 104 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
104 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81430 | 1 | 10 | 300 | $1,590 | $476.2K |
| 81419 | 1 | 10 | 150 | $2,400 | $427.1K |
| 87798 | 6 | 40 | 1,090 | $30 | $188.7K |
| G0483 | 17 | 30 | 140 | $240 | $134.2K |
| 81185 | 2 | 10 | 70 | $830 | $81.8K |
| 81302 | 1 | 10 | 180 | $520 | $75.9K |
| 81325 | 2 | 10 | 50 | $760 | $71.9K |
| 87481 | 13 | 40 | 360 | $30 | $70.3K |
| 81238 | 1 | 10 | 100 | $590 | $60.6K |
| 81223 | 1 | 10 | 120 | $480 | $57.7K |
Showing 1–10 of 104
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.
73 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 480 | $50 | $26.1K |
| 81419 | The lab analyst performs the technical lab test on a specimen such as blood to conduct a genomic sequence analysis panel. The test evaluates the genetic sequences of at least the 24 genes listed in… | 270 | $60 | $16K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 680 | $10 | $5.4K |
| 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… | 90 | $10 | $1K |
| 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. | 400 | $1 | $800 |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 230 | $1 | $680 |
| 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… | 340 | $1 | $670 |
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 70 | $10 | $670 |
| 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. | 580 | $1 | $580 |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 570 | $1 | $570 |
Showing 1–10 of 73
How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oklahoma median
73 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 12 | 20 | 60 | $60 | $404.2K |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 4 | 10 | 40 | $10 | $267.7K |
| 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. | 64 | 100 | 630 | $50 | $197.2K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 13 | 10 | 200 | $120 | $190.9K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 19 | 50 | 170 | $30 | $163.4K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 19 | 50 | 200 | $30 | $163.3K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 12 | 30 | 410 | $130 | $127.9K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 9 | 20 | 300 | $30 | $116.3K |
| 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… | 28 | 80 | 280 | $20 | $72.5K |
| 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. | 95 | 150 | 1,280 | $10 | $67.8K |
Showing 1–10 of 73
Other providers in the same ZIP code as Vanguard Laboratory Innovations, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Tulsa Spine & Specialty Hospital | OK | General Acute Care Hospital | $0 | $5.5M |
| Dental Depot Southern Hills 71st & Jackson | OK | Dental Clinic/Center | $0 | $4.3M |
| Medical Motion, L.L.C. | OK | Durable Medical Equipment & Medical Supplies | $0 | $2.6M |
| John Saurino | OK | Ophthalmology Physician | $2.2M | $0 |
| Olympia Anesthesia, Plc | OK | Anesthesiology Physician | $0 | $1.8M |
| Williams Medical Group Practice, LLC | OK | Rural Health Clinic/Center | $0 | $1.8M |
| Osu Center For Health Sciences | OK | Medical Specialty Clinic/Center | $0 | $1.7M |
| Alison Fischer | OK | Dermatology Physician | $490.5K | $25.2K |
| Hayley Sewell | OK | Physician Assistant | $310.7K | $0 |
| Kristin King | OK | Neurology Physician | $261.1K | $0 |
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.