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NPI 1780620526 · San Juan Capistrano, CA · Clinical Medical Laboratory
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Quest Diagnostics Nichols Institute is a clinical medical laboratory provider located in San Juan Capistrano, California. This profile covers 355 Medicare and 406 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 Nichols Institute |
| Address | 33608 Ortega Hwy |
| City | San Juan Capistrano |
| State | CA |
| ZIP | 92675 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $39.9M |
| Medicare | $5.6M |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
355 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 84,810 | $20 | $1.9M |
| 88120 | The lab analyst performs a technical lab test on a urinary tract specimen using in situ hybridization and three to five molecular probes for manual morphometric analysis, looking at the number and… | 780 | $500 | $392.8K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 4,220 | $70 | $295.3K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 4,530 | $70 | $294.3K |
| 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… | 2,280 | $110 | $255.5K |
| 83921 | The lab analyst measures the single organic acid analyte ordered, which may be any one of the more than 60 identified organic acid analytes. The specimen type may be serum, plasma, urine, amniotic… | 4,980 | $20 | $104.5K |
| 82024 | The lab analyst measures this analyte, also known as corticotropin, quantitatively to aid in the diagnosis of many hormone dependent conditions or diseases. This test can help determine the… | 2,550 | $40 | $96.8K |
| 86334 | The lab analyst performs immunofixation electrophoresis, typically on the patient’s serum, to diagnose and or monitor monoclonal gammopathies or myeloma, a bone marrow tumor. | 4,360 | $20 | $95.9K |
| 82784 | The lab analyst performs the technical lab test to analyze the concentration of a particular gamma globulin in the specimen. The analyst may test for immunoglobulin A, immunoglobulin D,… | 10,150 | $10 | $91.3K |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 220 | $370 | $81.9K |
Showing 1–10 of 355
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 355 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
355 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 13 | 20 | 650 | $2,290 | $16.6M |
| G0483 | 50 | 70 | 360 | $240 | $427.9K |
| 87798 | 99 | 110 | 1,340 | $30 | $338.2K |
| 88185 | 1 | 40 | 1,560 | $20 | $139.2K |
| 81206 | 2 | 10 | 200 | $160 | $123.5K |
| 88120 | 2 | 20 | 120 | $400 | $122.8K |
| G0480 | 5 | 50 | 70 | $110 | $119.4K |
| 86235 | 37 | 60 | 1,220 | $20 | $75.7K |
| 87799 | 8 | 20 | 420 | $40 | $72.5K |
| 80307 | 69 | 150 | 220 | $60 | $69.2K |
Showing 1–10 of 355
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.
406 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 34,230 | $280 | $9.4M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 39,800 | $160 | $6.4M |
| 81443 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The… | 3,360 | $650 | $2.2M |
| 81329 | The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,… | 25,920 | $70 | $1.8M |
| 87799 | The lab analyst performs a test to quantify infection with an infectious agent, not otherwise specified in another code, using a nucleic acid probe technique. Use this code if you know the laboratory… | 17,070 | $60 | $972.8K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 18,510 | $50 | $962.5K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 24,010 | $40 | $840.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 23,920 | $40 | $837.2K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 4,250 | $180 | $777.9K |
| 87901 | The lab analyst performs the technical lab test to analyze the patient specimen, typically serum, for the reverse transcriptase and protease regions of the specific genotype of the virus causing the… | 3,310 | $150 | $495.8K |
Showing 1–10 of 406
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
406 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 7 | 30 | 300 | $260 | $18M |
| 81511 | The lab analyst performs the technical lab tests for four analytes, AFP, uE3, hCG, and DIA, and carries out an algorithmic analysis using patient data and the lab test results to report a patient… | 2 | 10 | 1,270 | $220 | $16.9M |
| 81508 | The lab analyst performs the technical lab tests for two proteins, PAPP–A and hCG, and carries out an algorithmic analysis using patient data and the lab test results to report a patient risk score. | 5 | 10 | 5,070 | $210 | $16.6M |
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 11 | 10 | 440 | $500 | $5.3M |
| 81443 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The… | 4 | 10 | 3,040 | $290 | $4.7M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 8 | 110 | 190 | $140 | $1.6M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 15 | 50 | 500 | $160 | $1.1M |
| 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… | 164 | 750 | 950 | $50 | $890K |
| 81257 | The lab analyst performs the technical lab test to detect the presence of specific changes and possible deleted nucleotides in the alpha globin 1 and alpha globin 2 genes, also known as HBA1/HBA2,… | 5 | 10 | 1,960 | $20 | $830.3K |
| 81329 | The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,… | 7 | 60 | 400 | $40 | $748.5K |
Showing 1–10 of 406
Other providers in the same ZIP code as Quest Diagnostics Nichols Institute, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Camino Health Center | CA | Community Health Clinic/Center | $0 | $29.7M |
| Pmdtc, LLC | CA | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | $1.3M | $2.6M |
| Maria Theresa Baylon | CA | Physical Therapist | $848.7K | $0 |
| William Chang | CA | Pulmonary Disease Physician | $389.1K | $426K |
| Alerra, LLC | CA | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | $398.3K | $290K |
| Sanjivan Kohli | CA | Pulmonary Disease Physician | $504.4K | $0 |
| Yen-hui Soong | CA | Pulmonary Disease Physician | $365.5K | $0 |
| Ralf Reuland | CA | Family Medicine Physician | $151.8K | $0 |
| Eric Loo | CA | Anatomic Pathology & Clinical Pathology Physician | $27K | $0 |
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