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NPI 1790023547 · Montvale, NJ · Clinical Medical Laboratory
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Advanced Molecular Diagnostics, LLC is a clinical medical laboratory provider located in Montvale, New Jersey. This profile covers 20 Medicare and 56 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 | Advanced Molecular Diagnostics, LLC |
| Address | 136 Summit Avenue |
| City | Montvale |
| State | NJ |
| ZIP | 07645 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 29, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $39.8M |
| Medicare | $4.1M |
ADVANCED MOLECULAR DIAGNOSTICS, LLC operates as a specialized clinical molecular laboratory in MONTVALE, NJ with a test mix dominated by high-complexity molecular and genetic assays (examples on file include pharmacogenomics codes 81226 and 81225, hereditary cancer sequencing 81162 and PALB2 81307, and multiplex respiratory testing 87636). The presence of multiple Tier 2 molecular pathology codes in the top Medicaid revenue list (81408, 81406, 81405, 81404) further indicates a core business built on genomic panels and sequencing services rather than routine clinical lab work.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 79.8% of this provider's total Medicare revenue, driven chiefly by 87636 ($2.1M, 50.6% of Medicare revenue), 81226 ($714.7K, 17.3%), and 81225 ($491.6K, 11.9%). This concentration shows the provider’s Medicare activity depends largely on a few high-revenue molecular and multiplex infectious-disease tests.
Medicaid revenue is substantial but less concentrated at the top: the precomputed top 3 Medicaid codes account for 42.8% of total Medicaid revenue, with 81408 ($5.7M, 15.2%), 81406 ($5.3M, 14.0%), and 87636 ($5.1M, 13.6%) together forming the largest Medicaid revenue block. The Medicaid top codes are primarily Tier 2 molecular pathology and high-volume multiplex testing, indicating broad uptake of genomic panels in the state program.
The provider’s payer mix is heavily skewed toward Medicaid by scale: reported lifetime Medicaid revenue is $39.8M versus $4.1M in Medicare, making Medicaid the dominant source of billed revenue on file. This suggests operational focus and commercial relationships are more oriented to state Medicaid contracts and populations than to Medicare volume.
Competitive standing on Medicare shows national outlier performance for several codes: 87636 ranks #3 of 2192 providers nationally (100th percentile; extreme outlier), 81225 ranks #2 of 78 (99th percentile; extreme outlier), and 81226 ranks #3 of 77 (97th percentile; notably above typical national volume). These rankings indicate the lab is a major national player for specific high-revenue molecular assays and multiplex respiratory testing within the Medicare universe.
On Medicaid the provider is a clear in-state leader for many specialized tests: 81408 and 81406 both rank #1 of 11 providers in-state (100th percentile; notably above typical state volume) and 87636 ranks #1 of 68 in-state (100th percentile; extreme outlier). Multiple other molecular pathology codes (for example 81162, 81405, 81404, 81321, 81298) also rank #1 in-state, signaling statewide dominance across a broad set of genomic services.
Operational signals point to high-throughput specimen collection and multiplex testing capacity: 87636 shows 14.9K Medicare claims and 51.9K Medicaid claims with large revenue contributions ($2.1M Medicare, $5.1M Medicaid), and specimen-collection code G2023 appears with 10.9K Medicare claims ($251.6K) and 28.5K Medicaid claims ($371K). These volumes are consistent with a laboratory network that processes large specimen volumes and supports centralized testing workflows.
The provider has an established enrollment history—NPI enumerated 2013-01-29 (~13 years ago)—and the breadth of high-level molecular codes billed (pharmacogenomics, CFTR 81220, BRCA panels 81162, multiple MLH/MSH genes) indicates a sustained multi-year focus on hereditary and pharmacogenomic testing in addition to respiratory infectious-disease panels. This combination of tenure and a specialized test menu supports its role as a mature, niche molecular diagnostics operator in the state and for select Medicare codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 14,910 | $140 | $2.1M |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 1,620 | $440 | $714.7K |
| 81225 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19. | 1,720 | $290 | $491.6K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 10,940 | $20 | $251.6K |
| 81328 | The lab analyst performs the technical lab test to detect the presence of specific changes in the solute carrier organic anion transporter family, member 1B1 (SLCO1B) gene for common variants, such… | 1,310 | $170 | $224.7K |
| 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… | 60 | $1,790 | $101.9K |
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 60 | $660 | $42.4K |
| 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… | 820 | $50 | $40.8K |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 60 | $630 | $40.3K |
| 81227 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 9, also known as CYP2C9. | 170 | $170 | $28.4K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81307 | 5 | 10 | 910 | $660 | $635.4K |
| 81317 | 5 | 10 | 60 | $660 | $511.5K |
| 81298 | 5 | 10 | 60 | $630 | $489.5K |
| 81162 | 6 | 10 | 80 | $1,790 | $271.4K |
| 81226 | 1 | 10 | 50 | $440 | $133.4K |
| 81295 | 5 | 10 | 170 | $370 | $108.6K |
| U0003 | 57 | 80 | 110 | $70 | $101.7K |
| 81225 | 1 | 10 | 30 | $290 | $94.1K |
| 87636 | 1 | 30 | 20 | $140 | $84.7K |
| 81328 | 1 | 10 | 80 | $170 | $53.7K |
Showing 1–10 of 20
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.
56 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81408 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code. | 5,920 | $970 | $5.7M |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 7,470 | $710 | $5.3M |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 51,940 | $100 | $5.1M |
| 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… | 6,900 | $560 | $3.9M |
| 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… | 2,330 | $1,120 | $2.6M |
| 81405 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 6 molecular pathology code. | 7,420 | $290 | $2.2M |
| 81255 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for hexosaminidase A [alpha polypeptide], also known as HEXA. | 5,210 | $270 | $1.4M |
| 81211 | N/A | 720 | $1,770 | $1.3M |
| 81404 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 5 molecular pathology code. | 6,770 | $180 | $1.2M |
| 81407 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 8 molecular pathology code. | 3,340 | $270 | $891.8K |
Showing 1–10 of 56
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
56 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 60 | 130 | 3,180 | $60 | $4.2M |
| 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… | 4 | 30 | 210 | $200 | $1.3M |
| 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,… | 92 | 140 | 5,590 | $20 | $823.1K |
| 81408 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code. | 1 | 10 | 50 | $710 | $555.2K |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 1 | 10 | 50 | $520 | $493.7K |
| 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… | 1 | 10 | 140 | $1,000 | $493.3K |
| 81211 | N/A | 1 | 10 | 60 | $1,610 | $441.7K |
| 81255 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for hexosaminidase A [alpha polypeptide], also known as HEXA. | 2 | 10 | 3,260 | $100 | $363.9K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 1 | 70 | 450 | $60 | $345.9K |
| 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,… | 4 | 10 | 210 | $30 | $302.5K |
Showing 1–10 of 56
Other providers in the same ZIP code as Advanced Molecular Diagnostics, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gwen Abeles | NJ | Procedural Dermatology Physician | $1M | $0 |
| Harlan Levine | NJ | Orthopaedic Surgery Physician | $520.2K | $0 |
| Samir Sodha | NJ | Orthopaedic Surgery Physician | $229.3K | $0 |
| Diana Roth O'brien | NJ | Radiation Oncology Physician | $189.2K | $0 |
| Rick Lambert | NJ | Internal Medicine Physician | $125.2K | $0 |
| Edward Harris | NJ | Foot & Ankle Surgery Podiatrist | $119.3K | $0 |
| Ara Ajemian | NJ | Family Medicine Physician | $106.7K | $0 |
| Rebecca Varghese | NJ | Internal Medicine Physician | $98.3K | $0 |
| Gabriela Wojnarska-alvarez | NJ | Nephrology Physician | $82.9K | $0 |
| Kerri Kopczuk | NJ | Surgical Physician Assistant | $6.2K | $0 |
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