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NPI 1831674084 · Charleston, WV · Clinical Medical Laboratory
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Appalachian Labs Of Wv LLC is a clinical medical laboratory provider located in Charleston, West Virginia. This profile covers 19 Medicare and 45 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 | Appalachian Labs Of Wv LLC |
| Address | 708 Bigley Ave. |
| City | Charleston |
| State | WV |
| ZIP | 25302 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 3, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $11M |
| Medicare | $359.3K |
APPALACHIAN LABS OF WV LLC is a clinical medical laboratory focused heavily on definitive drug testing: its Medicare top three codes are all G0482/G0480/G0481 and the provider reports that the top 3 Medicare codes by revenue account for 98.0% of its Medicare revenue, indicating the Medicare business is almost entirely driven by high-complexity drug confirmation testing rather than routine chemistries or panels. The Medicaid top three codes similarly concentrate on definitive drug testing and account for 93.5% of its Medicaid revenue, reinforcing that its core service line across payers is drug-confirmation toxicology.
Medicaid volume dwarfs Medicare for this provider: lifetime Medicaid revenue is $11M versus total Medicare revenue of $359.3K, so the provider operates with a predominantly Medicaid-facing revenue base and is effectively single-payer–weighted toward Medicaid in scale. Both payer datasets show the same service specialization in definitive and presumptive drug testing, but Medicaid represents the principal revenue stream.
APPALACHIAN LABS shows an extreme in-state competitive position on key Medicaid drug-testing codes: it ranks #1 of 18 for G0482 and #1 of 54 for G0480 in West Virginia and is described as an "extreme outlier, far above typical state volume for this code." This indicates the lab is functionally dominant in Medicaid-definitive drug testing in-state and likely captures referral or contract volume that other in-state labs do not.
By contrast, its national standing on Medicare for the same definitive drug-testing codes is strong but not unique: G0482 ranks #77 of 1618 (95th percentile) and G0480 ranks #100 of 1590 (94th percentile) nationally, which the source frames as "typical, unremarkable volume for this code" despite high percentiles. This suggests APPALACHIAN LABS is a meaningful national participant on Medicare for these tests, but not an extreme national outlier.
Service mix beyond toxicology is minimal on Medicare and Medicaid: routine panels and common analytes (examples: 82306 vitamin D, 80053 CMP, 80061 lipid panel, 84443 TSH, 85025 CBC) each represent only small shares of Medicare revenue (individual entries at 0.1–0.3% of Medicare revenue) and modest Medicaid revenue contributions, indicating the lab does not appear to run broad primary-care panel volumes and is specialized in substance-testing services.
The provider has been NPI-enumerated since 2018-10-03 (~8 years ago), establishing a multi-year operational history that aligns with the large accumulated Medicaid claim counts reported (e.g., 116.8K G0482 claims; 71.6K G0480 claims) and supporting the interpretation that the in-state Medicaid dominance developed over several years rather than appearing overnight.
Although definitive drug-testing codes dominate, there are notable ancillary Medicaid code positions where the provider ranks at or near the top in-state (for example 87511 ranks #1 of 2 in-state and 86708 ranks #1 of 11 in-state), suggesting APPALACHIAN LABS offers a suite of infectious disease and NAAT services in addition to its core toxicology business and may serve as a centralized lab for multiple test types within Medicaid networks.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0482 | 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… | 970 | $190 | $184.5K |
| 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… | 950 | $110 | $106.8K |
| 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… | 400 | $150 | $60.9K |
| 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… | 40 | $30 | $1.1K |
| 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. | 100 | $10 | $1K |
| 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. | 80 | $10 | $990 |
| 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… | 60 | $20 | $900 |
| 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… | 70 | $10 | $590 |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 20 | $20 | $460 |
| 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).… | 40 | $10 | $410 |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
45 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0482 | 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… | 116,770 | $50 | $6.1M |
| 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… | 71,620 | $60 | $3.9M |
| 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. | 7,100 | $30 | $220.2K |
| 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… | 3,910 | $40 | $160.1K |
| 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… | 1,630 | $90 | $145.1K |
| G0483 | 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… | 3,690 | $10 | $47.9K |
| 87529 | The lab analyst performs a test for Herpes simplex virus, HSV, using amplified nucleic acid probe technique. HSV causes clusters of blisters, or vesicles, on different parts of the body and spreads… | 1,360 | $40 | $47.6K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 2,460 | $10 | $29.5K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 1,360 | $20 | $25.8K |
| 87511 | The lab analyst performs a test for Gardnerella vaginalis using amplified nucleic acid probe technique. Gardnerella vaginalis, typically causes bacterial vaginosis, an infection of the vagina that… | 1,360 | $20 | $25.8K |
Showing 1–10 of 45
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
45 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 5 | 20 | 270 | $20 | $1.5M |
| G0482 | 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… | 1 | 20 | 1,050 | $80 | $1.3M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 20 | 40 | 820 | $30 | $1.2M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 20 | 40 | 820 | $30 | $1.2M |
| 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… | 4 | 30 | 180 | $40 | $773.3K |
| 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. | 32 | 110 | 2,080 | $50 | $537.1K |
| 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… | 1 | 50 | 800 | $70 | $504.4K |
| 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… | 8 | 20 | 690 | $80 | $346.6K |
| 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. | 68 | 110 | 5,530 | $20 | $344.8K |
| 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… | 69 | 140 | 3,080 | $20 | $243.1K |
Showing 1–10 of 45
Other providers in the same ZIP code as Appalachian Labs Of Wv LLC, ranked by combined Medicare and Medicaid revenue.
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