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NPI 1891731626 · Tampa, FL · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Tampa, Florida. This profile covers 642 Medicare and 495 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 Clinical Laboratories Inc |
| Address | 4225 E Fowler Ave |
| City | Tampa |
| State | FL |
| ZIP | 33617 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $107.1M |
| Medicaid | $50M |
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC operates as a high-volume clinical diagnostic reference laboratory: its Medicare top revenue drivers are routine panels and commonly ordered assays such as 80053, 80061 and 84443, and its billing mix includes very large volumes of collection/processing activity (for example 36415 with 913.4K claims). The prominence of comprehensive metabolic panels, lipid panels, TSH and CBCs in the top Medicare codes indicates a business model centered on high-throughput outpatient specimen processing and widespread collection sites.
Revenue concentration is meaningful on both payers: the provider’s top three Medicare codes account for 34.1% of its Medicare revenue and the top three Medicaid codes account for 35.2% of its Medicaid revenue. On Medicaid the top three are led by U0003, 80061 and 87491, while on Medicare the top drivers include 80053, 80061 and 84443, showing that a relatively small set of tests produce a large share of payer-specific revenue.
Medicare is the larger payer by scale for this NPI: total Medicare revenue is $107.1M versus total Medicaid revenue of $50M, indicating the provider’s Medicare business is roughly larger in magnitude while Medicaid remains a significant secondary payer. Both payers are active sources of volume rather than the provider being effectively single-payer.
Nationally the provider is a dominant player for many commonly ordered lab tests: multiple top Medicare codes (for example 80053 rank #4 of 26416, 80061 rank #3 of 21671, 84443 rank #4 of 19722 and 36415 rank #3 of 86467) are labeled “extreme outlier” or show 100th percentile rankings, which positions the provider far above typical national volume for these codes. This national dominance for routine assays and specimen collection suggests market leadership in reference testing for Medicare beneficiaries.
State-level rankings show similar dominance in Florida Medicaid for core services: U0003 (COVID PCR) is 84K claims and $5.3M revenue and ranks #5 of 320 in-state as an “extreme outlier,” while 80061, 87491 and several other routine panels rank in the top three or four in-state and are frequently at the 99–100th percentile. These high state percentiles indicate the provider is a major Medicaid lab operator in Florida across both infectious-disease and routine chemistry test lines.
Operational footprint appears broad: extremely high claim counts for specimen collection and routine panels (e.g., 36415 with 913.4K claims, 80053 with 832.5K claims, 85025 with 684.4K claims) plus notable volumes of specialized testing (G0480, 81420, and multiple molecular/infectious codes like U0003 and 87491) point to a centralized high-throughput laboratory with an extensive outpatient collection network and capability to run both high-volume screening assays and higher-complexity testing.
The provider’s test mix contains many statistically flagged outliers across both payers — numerous Medicare and Medicaid codes are explicitly described as “extreme outlier” or “notably above typical” (examples include 80053, 80061, 84443, 82306, 85025 on Medicare and U0003, 80061, 87491, 87086 on Medicaid). At the same time, a few services show typical or unremarkable state-level volumes (for example 81420 is reported at the 50th percentile in-state), indicating the enterprise combines exceptionally high-volume routine work with expected volumes for some niche or high-complexity panels.
The NPI tenure supports an established operation: enumerated on 2006-06-21 (~20 years ago), this long-standing enrollment aligns with sustained national and state-level volume and rankings, consistent with a mature national reference laboratory platform rather than a new entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
642 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 832,510 | $10 | $8.3M |
| 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. | 638,190 | $10 | $8.3M |
| 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… | 493,010 | $20 | $7.9M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 913,390 | $10 | $7.3M |
| 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… | 218,650 | $30 | $6.3M |
| 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… | 684,450 | $10 | $5.5M |
| 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).… | 381,150 | $10 | $3.8M |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 208,060 | $20 | $3.1M |
| 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. | 59,410 | $40 | $2.4M |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 200,000 | $10 | $1.8M |
Showing 1–10 of 642
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 642 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
642 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81450 | 3 | 10 | 20 | $740 | $322.2K |
| 87798 | 44 | 110 | 590 | $30 | $218.6K |
| 88237 | 7 | 10 | 140 | $140 | $175.8K |
| 81272 | 8 | 10 | 200 | $320 | $168.9K |
| 87801 | 7 | 60 | 450 | $70 | $166.5K |
| 83521 | 3 | 10 | 3,990 | $20 | $163.5K |
| 81305 | 17 | 20 | 80 | $170 | $118.8K |
| 81339 | 11 | 30 | 110 | $180 | $116.4K |
| 83013 | 1 | 10 | 1,640 | $70 | $107K |
| 81279 | 13 | 30 | 140 | $180 | $106.7K |
Showing 1–10 of 642
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.
495 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… | 84,020 | $60 | $5.3M |
| 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. | 688,370 | $10 | $3.4M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 264,870 | $10 | $2.9M |
| 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… | 237,440 | $10 | $2.1M |
| 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,… | 8,980 | $210 | $1.9M |
| 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).… | 449,230 | $1 | $1.8M |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 35,230 | $30 | $1.2M |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 71,880 | $20 | $1.1M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 263,590 | $1 | $1.1M |
| 87088 | The lab analyst or microbiologist observes a urine culture with an unknown organism or organisms and makes a presumptive identification of each organism that needs identification. | 170,500 | $10 | $1M |
Showing 1–10 of 495
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
495 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,… | 3 | 10 | 8,980 | $280 | $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 | 20 | 130 | $210 | $1.5M |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 3 | 10 | 28,880 | $30 | $1.4M |
| 83498 | The lab analyst measures the 17 hydroxyprogesterone in a sample such as blood, serum, urine, or even amniotic fluid. This hormone is a building block for the adrenal cortex hormone cortisol. | 4 | 10 | 7,990 | $10 | $932.8K |
| 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… | 32 | 40 | 320 | $100 | $620K |
| 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 | 9,150 | $60 | $584.1K |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 3 | 10 | 680 | $270 | $506.2K |
| 83789 | The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using mass spectrometry and tandem mass spectrometry. | 7 | 10 | 30 | $1 | $449.4K |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 3 | 20 | 620 | $30 | $423.4K |
| 80055 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen, a rubella antibody, a qualitative non… | 2 | 10 | 170 | $40 | $366K |
Showing 1–10 of 495
Other providers in the same ZIP code as Quest Diagnostics Clinical Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Best Care Providers Inc | FL | Home Health Agency | $0 | $15M |
| Total Renal Care Inc | FL | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $14.7M |
| Dva Healthcare Renal Care, Inc. | FL | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $12.7M |
| Bakotic Pathology Associates, LLC | FL | Clinical Medical Laboratory | $2.1M | $8.3K |
| Ameripath Florida LLC | FL | Clinical Medical Laboratory | $871.7K | $1.1M |
| Thomas Bernasek | FL | Orthopaedic Surgery Physician | $440.9K | $0 |
| Grant Garlick | FL | Orthopaedic Surgery Physician | $355.3K | $0 |
| Mark Frankle | FL | Orthopaedic Surgery Physician | $261.5K | $0 |
| Benjamin Maxson | FL | Orthopaedic Surgery Physician | $232.9K | $0 |
| Alfred Hess | FL | Orthopaedic Surgery Physician | $172.8K | $0 |
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