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NPI 1912903717 · North Kingstown, RI · Clinical Medical Laboratory
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Dominion Diagnostics, LLC is a clinical medical laboratory provider located in North Kingstown, Rhode Island. This profile covers 43 Medicare and 122 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 | Dominion Diagnostics, LLC |
| Address | 211 Circuit Drive |
| City | North Kingstown |
| State | RI |
| ZIP | 02852 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 27, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $249.1M |
| Medicare | $4.8M |
Dominion Diagnostics operates at scale primarily as a clinical/toxicology laboratory: its Medicare billing is concentrated in definitive and presumptive drug-testing codes (G0480, 80307, G0481) and its Medicaid billing is overwhelmingly driven by the same drug-testing mix plus high-volume molecular COVID testing (U0003). The Medicare top codes include G0480 ($2.6M, 54.3% of Medicare revenue), 80307 ($1.6M, 33.3%), and G0481 ($442.2K, 9.2%), while Medicaid shows very large volumes for 80307 (2.8M claims, $119.4M) and G0480 (1.6M claims, $88.9M).
Revenue concentration is extremely high for both payers: the provider's top three Medicare codes account for 96.9% of Medicare revenue and the top three Medicaid codes account for 94.9% of Medicaid revenue. This indicates a narrowly concentrated service line where a small set of toxicology and definitive drug-testing procedures generate the vast majority of billed dollars across both payers.
The payer mix is heavily skewed toward Medicaid in absolute scale: total Medicaid revenue is $249.1M compared with total Medicare revenue of $4.8M, making Medicaid the dominant payer by a wide margin. Although both payers show the same specialty service lines, Medicaid volumes (e.g., 80307 at 2.8M claims and G0480 at 1.6M claims) are orders of magnitude larger than Medicare claim counts, indicating different contractual or referral dynamics between the two programs.
Dominion is a national outlier on several high-revenue Medicare codes and a statewide leader on Medicaid: on Medicare, G0480 ranks #2 of 1590 providers (100th percentile; extreme outlier) and 80307 ranks #5 of 4760 providers (100th percentile; extreme outlier), while in Rhode Island the provider ranks #1 of state peers for 80307, G0480, and G0481 (100th percentile). These rank signals support characterization as a dominant specialist for drug-testing services nationally on Medicare benchmarks and the clear market leader in-state for the same codes on Medicaid.
The code-level mix shows a specialization in multi-class definitive testing and high-volume presumptive screening with integrated specimen validity testing (G0480, G0481, 80307), plus substantial state-level volumes in ancillary drug-panel codes (80346, 80349, 80354, 80361, etc.) and high-throughput SARS-CoV-2 molecular testing (U0003 with 91.2K Medicaid claims, $5.6M). That pattern suggests an operational model built around centralized, high-throughput toxicology workflows and the capacity to support mass infectious-disease testing when contracted by payers or public programs.
Statistical standing language in the source supports that several of the provider's code-level volumes are far above typical peers: Medicare top codes are labeled “extreme outlier” or “notably above typical,” and many Medicaid codes are ranked #1 in-state (100th percentile) or show extreme outlier status. These labels indicate the provider’s volumes and billing for core toxicology services are exceptional relative to both national Medicare and in-state Medicaid peers, which is relevant for competitor benchmarking or capacity planning.
Payment profile and unit economics differ by payer: Medicaid volumes are much larger but paid at lower averages per claim (example: Medicaid 80307 avg paid/claim $43 on 2.8M claims) compared with smaller Medicare volumes billed at higher avg paid/claim (Medicare 80307 avg paid/claim $61 on 26.1K claims). This combination—very high Medicaid throughput with lower unit payments and smaller but higher-unit-value Medicare business—suggests revenue scale is driven primarily by Medicaid contract volumes while Medicare contributes a smaller but higher-margin component.
The provider has long tenure in the file (NPI enumerated 2005-06-27, ~21 years ago), which combined with the concentrated high-volume toxicology footprint and repeated top-ranked positions in-state implies an established, specialized lab business rather than a recent entrant. For payer/provider analysts, that longevity plus concentrated code dominance supports treating Dominion as a stable, specialized competitor or high-volume contractor for drug-testing and related laboratory services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
43 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 23,190 | $110 | $2.6M |
| 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. | 26,110 | $60 | $1.6M |
| 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… | 2,890 | $150 | $442.2K |
| 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… | 430 | $190 | $84K |
| 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… | 240 | $70 | $17.5K |
| 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,… | 240 | $30 | $5.9K |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 220 | $30 | $5.5K |
| 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. | 520 | $10 | $5.2K |
| 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… | 580 | $10 | $4.6K |
| 84146 | The analyst performs the technical test using clinical laboratory instruments to analyze specimens, typically serum or plasma, for prolactin, one of the hormones responsible for milk production after… | 160 | $20 | $3K |
Showing 1–10 of 43
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 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.
122 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 2,776,990 | $40 | $119.4M |
| 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… | 1,645,570 | $50 | $88.9M |
| 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… | 254,990 | $100 | $25M |
| 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… | 91,230 | $60 | $5.6M |
| 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,… | 63,300 | $20 | $949.6K |
| 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… | 10,260 | $70 | $687.3K |
| 80349 | The lab analyst measures the amount of or detects the presence of natural cannabinoids in a patient specimen. | 29,230 | $20 | $438.5K |
| 80346 | The lab analyst measures the amount of or detects the presence of one to twelve benzodiazepines, which are tranquilizers, in a patient specimen. | 26,520 | $20 | $424.3K |
| 80361 | The lab analyst measures the amount of or detects the presence of one or more opiates, narcotic analgesics that depress the central nervous system, in the specimen. | 22,970 | $20 | $390.4K |
| 80354 | The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen. | 27,380 | $10 | $383.3K |
Showing 1–10 of 122
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
122 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 1 | 10 | 310 | $100 | $4.2M |
| 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 | 30 | 260 | $60 | $3.4M |
| 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. | 1 | 50 | 330 | $50 | $2.7M |
| S5170 | Home delivered meals, including preparation; per meal | 2 | 10 | 170,610 | $10 | $2.1M |
| S5130 | Homemaker service, nos; per 15 minutes | 31 | 30 | 10,010 | $100 | $1.9M |
| T2022 | Case management, per month | 41 | 40 | 5,460 | $150 | $1.2M |
| H2015 | Comprehensive community support services, per 15 minutes | 2 | 10 | 40 | $110 | $834.2K |
| 80349 | The lab analyst measures the amount of or detects the presence of natural cannabinoids in a patient specimen. | 1 | 10 | 29,230 | $10 | $425.3K |
| 80346 | The lab analyst measures the amount of or detects the presence of one to twelve benzodiazepines, which are tranquilizers, in a patient specimen. | 1 | 10 | 26,520 | $20 | $415.3K |
| 80361 | The lab analyst measures the amount of or detects the presence of one or more opiates, narcotic analgesics that depress the central nervous system, in the specimen. | 1 | 10 | 22,970 | $20 | $395.8K |
Showing 1–10 of 122
Other providers in the same ZIP code as Dominion Diagnostics, LLC, ranked by combined Medicare and Medicaid revenue.
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