Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. North Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Laboratory Corporation Of America Holdings (NPI 1902809940)

Key Findings

Field	Value
Entity Type	Organization
Organization	Laboratory Corporation Of America Holdings
Address	531 S Spring St
City	Burlington
State	NC
ZIP	27215
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	May 23, 2005

Payer Source	Total Paid
Medicaid	$264.7M
Medicare	$0

This provider is effectively a single‑payer Medicaid operator: there is no Medicare billing on file and total Medicaid revenue is $264.7M. Analysts should treat this profile as Medicaid‑centric when assessing network exposure or utilization patterns.

Revenue is highly concentrated in a few tests: the precomputed top three Medicaid codes (U0003, 80307, 81420) account for 47.0% of the provider’s total Medicaid revenue. Individually those codes are U0003 $58.7M (28.9%), 80307 $22.9M (11.3%), and 81420 $13.8M (6.8%), indicating a small set of services drive nearly half of Medicaid receipts.

The coding mix points to a large, high‑throughput clinical laboratory operation that combines pandemic molecular testing, toxicology, genomics, and routine clinical chemistry. High volumes for SARS‑CoV‑2 molecular codes (U0003 and U0005), definitive drug testing (G0483/G0480/G0481 and 80307), and prenatal/genomic panels (81420, 81220, 81229) indicate the lab processes both mass surveillance/infectious workload and higher‑priced specialty diagnostics.

Competitive standing within the state is dominant for several high‑volume codes: U0003 ranks #2 of 158 providers (99th percentile; extreme outlier), 80307 ranks #3 of 362 (99th percentile; extreme outlier), and 86769 ranks #1 of 31 (100th percentile; extreme outlier). Routine and common panels also show above‑typical state volume (for example, 80053 #3 of 289, 85025 #3 of 608, 83036 #3 of 554), underscoring the provider’s role as a major Medicaid testing hub in‑state.

Multiple specific codes are flagged as statistical outliers in the statewide comparison, which signals single‑provider concentration risk for those services: the data labels U0003, U0005, 80307, and 86769 as "extreme outlier" or equivalent. Payers and provider networks should note that these codes may represent critical capacity points where this lab is relied on far more than typical peers.

The provider’s product mix balances very high‑volume, low‑paid claims with lower‑volume, higher‑paid specialty tests—illustrated by 81420 averaging $602 paid/claim (22.9K claims, $13.8M) versus routine panels such as 80053 averaging $7 paid/claim (809.8K claims, $5.7M) and 85025 averaging $3 paid/claim (803.3K claims, $2.4M). This blend suggests revenue stability driven both by scale in routine testing and by price per claim in specialty diagnostics.

Operational tenure is long: NPI enumerated 2005-05-23 (~21 years ago), which supports interpretation that the provider is an established laboratory with sustained Medicaid engagement. Longevity combined with the volume profile is consistent with an entrenched processing and logistics footprint in the state.

For payer contracting and utilization management, the concentration of Medicaid revenue and the provider’s top ranks for several codes present both leverage and operational considerations: the top 3 codes’ 47.0% share and multiple 99th/100th percentile rankings mean changes in coverage, reimbursement, or specimen routing could materially shift state Medicaid flows. Monitoring utilization trends for U0003, 80307, U0005, and 86769 should be prioritized given their outsized share and outlier status.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

547 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…	978,200	$60	$58.7M
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.	588,420	$40	$22.9M
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,…	22,940	$600	$13.8M
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…	84,310	$160	$13.1M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	451,860	$20	$9M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	453,260	$20	$8.6M
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,…	507,520	$10	$7.1M
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…	344,860	$20	$6.9M
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.	809,800	$10	$5.7M
86769	The lab analyst performs a multiple–step immunoassay to evaluate the patient’s serum for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), which causes coronavirus disease…	155,470	$40	$5.6M

Showing 1–10 of 547

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. North Carolina Distribution

Laboratory Corporation Of America Holdings — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

547 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	20	240	$400	$13.6M
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	170	$260	$2.6M
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…	2	160	840	$70	$2.3M
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	$480	$1.9M
87902	The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus.	2	10	1,360	$150	$1.8M
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…	4	110	1,450	$110	$1.7M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	2	40	480	$40	$1.4M
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…	2	80	420	$30	$1.2M
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	10	410	$610	$1M
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…	2	10	260	$150	$977.9K

Showing 1–10 of 547

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$60.5M	$289.1M
Laboratory Corporation Of America	AZ	Clinical Medical Laboratory	$38.5M	$265.9M
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$3.5M	$281.4M
Inspira Medical Centers, Inc.	NJ	General Acute Care Hospital	$0	$227M
Laboratory Corporation Of America Holdings	WV	Clinical Medical Laboratory	$1.9M	$220M
Laboratory Corporation Of America	FL	Clinical Medical Laboratory	$47.4M	$171.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America	NC	Clinical Medical Laboratory	$0	$59.4M
Alamance Regional Medical Center, Inc.	NC	General Acute Care Hospital	$0	$30.8M
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$490.7K	$15.6M
Pinnacle Family Services Of North Carolina LLC	NC	Community/Behavioral Health Agency	$0	$12M
Alpha Diagnostics, LLC	NC	Clinical Medical Laboratory	$11M	$1M
A.r.t. Home Care, LLC	NC	In Home Supportive Care Agency	$0	$10M
Rha Behavioral Health Nc LLC	NC	Community/Behavioral Health Agency	$0	$10M
International Family Clinic	NC	Pediatrics Physician	$0	$8.5M
Grove Park Pediatrics	NC	Pediatrics Physician	$0	$8.5M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$8.1M

Laboratory Corporation Of America Holdings — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References