Loading...
NPI 1780001859 · Danville, VA · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Vista Clinical Diagnostics LLC is a clinical medical laboratory provider located in Danville, Virginia. This profile covers 134 Medicare and 90 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 | Vista Clinical Diagnostics LLC |
| Address | 3303 U S Highway 29 |
| City | Danville |
| State | VA |
| ZIP | 24540 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | March 26, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.3M |
| Medicaid | $3.3M |
Service mix indicates a combined stationary and mobile clinical laboratory operation: the provider’s Medicare and Medicaid top codes include travel allowances (P9603), skilled-nursing/home-collection venipuncture (G0471), and a broad set of routine panels and analytes (85025, 80053, 80048, 84443, 82306). The presence of high-volume specimen-collection codes alongside routine chemistry, hematology, and infectious disease assays (U0003 on Medicaid) is consistent with a lab that performs both point-of-care/homebound specimen pickup and high-throughput diagnostic testing.
Medicare revenue is highly concentrated in a single service line: the provider’s top 3 Medicare codes account for 65.2% of its Medicare revenue, with P9603 alone representing 47.8% of Medicare revenue (1.9M claims, $1.9M revenue). That concentration points to specimen-collection/mileage billing as the dominant Medicare revenue driver rather than just core lab analytics.
Medicaid revenue likewise shows concentration in a few codes: the top 3 Medicaid codes account for 50.7% of Medicaid revenue, led by U0003 at $675K (22.2% of Medicaid revenue) and P9603 at $622.8K (20.4% of Medicaid revenue). This split shows Medicaid revenue is driven by COVID PCR testing plus the same travel/collection service that dominates Medicare, making the provider dependent on a small set of high-revenue codes across both payers.
The provider has a meaningful dual-payer footprint: total Medicare revenue is $4.3M versus total Medicaid revenue of $3.3M, so Medicare is the larger single payer but Medicaid represents a substantial portion of lifetime revenue. This scale across both programs suggests a mixed contracting and utilization profile rather than being effectively single‑payer.
National Medicare competitive standing is notable for several codes: P9603 ranks #4 of 267 providers nationally (99th percentile; extreme outlier) and 80048 ranks #61 of 14725 (100th percentile; extreme outlier), while many routine tests (85025, 80053, 84443, 82306) sit at or near the top percentiles. These high national ranks indicate the provider operates at volumes far above most peers for both mobile collection and common lab tests, making it a major national participant for specific CPT/HCPCS codes.
In-state Medicaid competitive standing is similarly outsized for collection services and a few assays: P9603 ranks #1 of 7 providers in-state (100th percentile; notably above typical state volume) and G0471 is listed as #1 of 1 providers in-state (no state peer volume comparison available). Additionally, several assays (86141, 80164) are ranked #1 in-state (100th percentile; extreme outlier), showing a dominant position in particular Medicaid-billed tests and specimen-collection fees.
Claim counts and payment patterns reinforce an operational focus on mobile and high-volume testing: Medicare shows 1.9M claims for P9603 at $1 avg paid/claim ($1.9M revenue) and Medicaid shows 155.7K claims for P9603 at $622.8K revenue, while Medicaid’s U0003 appears with 14.4K claims and $675K revenue. Those absolute claim and revenue figures, paired with the rank/percentile annotations, support a profile of extensive specimen pickup operations coupled with significant high-throughput molecular testing during the reporting period.
The provider is established and persistent in claims activity: the NPI was enumerated on 2014-03-26 (~12 years ago), indicating an operating history long enough to build the observed payer relationships and volume patterns. Given the heavy concentration in a few codes and multiple extreme percentile rankings, analysts modeling network capacity, contracting strategies, or utilization management should pay particular attention to the P9603/G0471 collection channel and the high-volume routine and molecular assays that drive most revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
134 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 1,858,720 | $1 | $1.9M |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 45,610 | $10 | $456.1K |
| 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… | 27,640 | $10 | $221.1K |
| 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. | 19,130 | $10 | $191.3K |
| 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… | 10,060 | $20 | $160.9K |
| 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… | 4,450 | $30 | $129K |
| 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… | 15,480 | $10 | $123.8K |
| 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. | 6,910 | $10 | $89.8K |
| 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).… | 8,800 | $10 | $88K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 8,540 | $10 | $68.3K |
Showing 1–10 of 134
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 134 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
134 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G0471 | 1 | 10 | 45,610 | $10 | $471.7K |
| P9603 | 1 | 10 | 8,090 | $1 | $403.7K |
| 87798 | 32 | 30 | 690 | $30 | $159.2K |
| U0003 | 7 | 20 | 70 | $70 | $61.5K |
| P9604 | 1 | 10 | 2,410 | $10 | $21.5K |
| U0005 | 12 | 20 | 150 | $20 | $16.9K |
| 86480 | 5 | 10 | 120 | $60 | $15.1K |
| 83970 | 9 | 70 | 40 | $40 | $13.8K |
| 87631 | 1 | 10 | 40 | $140 | $13K |
| 87493 | 3 | 10 | 310 | $40 | $13K |
Showing 1–10 of 134
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.
90 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… | 14,360 | $50 | $675K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 155,710 | $1 | $622.8K |
| 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… | 82,290 | $1 | $246.9K |
| 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. | 55,520 | $1 | $222.1K |
| 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… | 13,020 | $10 | $156.3K |
| 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… | 49,830 | $1 | $149.5K |
| 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… | 22,870 | $10 | $114.4K |
| 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,… | 7,560 | $10 | $105.9K |
| 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. | 17,590 | $10 | $105.5K |
| 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).… | 26,190 | $1 | $104.8K |
Showing 1–10 of 90
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
90 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 171 | 170 | 3,790 | $40 | $415.2K |
| 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… | 17 | 20 | 1,790 | $70 | $347.5K |
| 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 | 110 | 1,150 | $40 | $331.1K |
| 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. | 21 | 230 | 5,240 | $1 | $93.2K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 1 | 10 | 7,870 | $1 | $89K |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 1 | 10 | 66,900 | $1 | $85.6K |
| 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,… | 8 | 30 | 190 | $30 | $78.1K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 39 | 90 | 380 | $50 | $76.5K |
| 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… | 23 | 30 | 150 | $70 | $69K |
| 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… | 115 | 230 | 300 | $40 | $65.4K |
Showing 1–10 of 90
Other providers in the same ZIP code as Vista Clinical Diagnostics 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.