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NPI 1932166386 · Tucker, GA · Clinical Medical Laboratory
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Quest Diagnostics Clinical Laboratories Inc is a clinical medical laboratory provider located in Tucker, Georgia. This profile covers 560 Medicare and 572 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 | 1777 Montreal Cir |
| City | Tucker |
| State | GA |
| ZIP | 30084 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $211.1M |
| Medicare | $53.3M |
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC is operating as a high-volume reference clinical laboratory based on its CPT mix; frequent, high-revenue codes include broad chemistry panels (80053, 80061), routine phlebotomy (36415), endocrine tests (84443), vitamin testing (82306), and both presumptive and definitive drug testing (80307, G0480). The presence of high-revenue specialized codes such as 81420 and 88305 further indicates capacity for genomic and pathology services in addition to core outpatient lab testing.
Revenue concentration is meaningful but not singular: the platform’s precomputed top-3 share calculations show the top 3 Medicare codes by revenue account for 33.3% of this provider's total Medicare revenue and the top 3 Medicaid codes by revenue account for 32.3% of this provider's total Medicaid revenue. This pattern indicates a reliance on a defined set of high-frequency tests while still maintaining a broad mix of additional billable services.
The payer mix is heavily weighted toward Medicaid by scale: total Medicaid revenue on file is $211.1M versus total Medicare revenue of $53.3M, so Medicaid represents the larger revenue stream for this NPI. Analysts should treat the entity as effectively Medicaid-dominant in absolute revenue terms while noting it still participates substantially in Medicare.
On Medicare-specific competitive standing, this NPI reports numerous extreme national outliers: codes such as 80053 (rank #10 of 26416, 100th percentile; extreme outlier), 80061 (rank #11 of 21671, 100th percentile; extreme outlier), 36415 (rank #13 of 86467, 100th percentile; extreme outlier) and many others appear far above typical national volume. These rank/percentile markers indicate the provider is a major national volume leader for routine clinical lab services billed to Medicare, consistent with a large reference-lab footprint.
On Medicaid within Georgia, the provider is a dominant statewide player for many high-revenue tests: U0003 (353.9K claims, $26.5M revenue) ranks #1 of 39 in-state (100th percentile; extreme outlier), 80307 (355.8K claims, $10M revenue) ranks #1 of 68 (100th percentile; extreme outlier), and multiple panels and infectious disease codes (80061, 80050, 82306, 84443, etc.) are also ranked #1 in-state at the 100th percentile. This consistent #1/100th-percentile pattern shows the provider captures substantially more state Medicaid volume for core assays than typical in-state peers.
The provider shows concentrated, high-throughput infectious disease and molecular testing activity on Medicaid: U0003 accounts for $26.5M (18.7% of Medicaid revenue) and 87801, 87491, 87591, 87389 and related nucleic-acid/amplified tests contribute multi-million-dollar revenues. That mix, combined with high claim counts for U0003 (353.9K claims) and other molecular codes, signals significant investment in high-throughput infectious disease PCR and STI screening capacity.
Drug-testing services are a material line across both payers: Medicaid shows large volumes for presumptive screening (80307, $10M) and definitive testing (G0480, $7M), while Medicare also reports meaningful revenue from G0480 ($1.8M) and 80307 ($1.1M). The simultaneous prominence and high ranks for presumptive and definitive drug-testing codes imply an integrated screening-and-confirmation workflow that generates substantial revenue on both Medicaid and Medicare.
The NPI has long tenure in Medicare/Medicaid files—enumerated 2006-04-28 (~20 years ago)—and the raw claim volumes support an enterprise-scale operation: examples include Medicare claim counts such as 477.6K for 36415 and Medicaid claim volumes like 1.3M for 80053 and 1.1M for 80061. These longevity and throughput signals are consistent with a mature, high-capacity reference laboratory rather than a small local outpatient lab.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
560 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. | 442,550 | $10 | $4.4M |
| 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. | 295,630 | $10 | $3.8M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 477,610 | $10 | $3.8M |
| 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… | 238,220 | $20 | $3.8M |
| 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… | 96,820 | $30 | $2.8M |
| 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… | 335,880 | $10 | $2.7M |
| 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… | 15,870 | $110 | $1.8M |
| 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).… | 158,680 | $10 | $1.6M |
| 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. | 33,710 | $40 | $1.3M |
| 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. | 18,050 | $60 | $1.1M |
Showing 1–10 of 560
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 560 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
560 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87999 | 1 | 10 | 1,900 | $230 | $441.1K |
| 83521 | 1 | 10 | 16,160 | $20 | $273.5K |
| 83704 | 1 | 10 | 5,960 | $30 | $199.4K |
| 81479 | 2 | 10 | 560 | $280 | $156.6K |
| 83698 | 1 | 10 | 3,020 | $50 | $137.2K |
| 87799 | 2 | 10 | 3,190 | $40 | $133.8K |
| 82024 | 1 | 10 | 3,350 | $40 | $126.7K |
| 87088 | 1 | 10 | 190 | $10 | $118.1K |
| 83520 | 1 | 10 | 7,930 | $20 | $117.6K |
| 83921 | 1 | 10 | 5,460 | $20 | $113.5K |
Showing 1–10 of 560
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.
572 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… | 353,880 | $80 | $26.5M |
| 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. | 355,810 | $30 | $10M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 546,880 | $20 | $9.3M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 538,610 | $20 | $9.2M |
| 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. | 1,094,430 | $10 | $7.7M |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 380,670 | $20 | $7.2M |
| 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… | 233,740 | $30 | $7M |
| 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. | 1,269,230 | $10 | $6.3M |
| 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… | 431,410 | $10 | $6M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 156,730 | $40 | $6M |
Showing 1–10 of 572
How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Georgia median
572 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2 | 10 | 11,550 | $310 | $3.5M |
| 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,… | 2 | 10 | 7,630 | $440 | $2.8M |
| 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… | 1 | 10 | 2,040 | $770 | $1.6M |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 1 | 10 | 53,760 | $30 | $1.5M |
| 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… | 1 | 40 | 850 | $70 | $983K |
| 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… | 1 | 10 | 90 | $40 | $923.5K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 1 | 10 | 9,140 | $100 | $913.6K |
| 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 | 30 | 2,370 | $100 | $757.4K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 1 | 10 | 900 | $40 | $638.4K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 1 | 10 | 140 | $20 | $529.9K |
Showing 1–10 of 572
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 |
|---|---|---|---|---|
| Vision Medical Consulting, P.C. | GA | Family Medicine Physician | $0 | $4.6M |
| Quest Diagnostics Clinical Laboratories Inc | GA | Clinical Medical Laboratory | $0 | $3.7M |
| Atlanta Heart Specialists LLC | GA | Cardiovascular Disease Physician | $0 | $2.2M |
| Jairus Robinson | GA | Clinical Social Worker | $0 | $691.9K |
| Sandeep Chandra | GA | Interventional Cardiology Physician | $363.7K | $0 |
| Zoubin Alikhani | GA | Clinical Cardiac Electrophysiology Physician | $354.8K | $0 |
| David Song | GA | Interventional Cardiology Physician | $339K | $0 |
| David Suh | GA | Cardiovascular Disease Physician | $318.4K | $0 |
| Binu Kunjummen | GA | Interventional Cardiology Physician | $198.8K | $0 |
| Terence Frinks | GA | Family Medicine Physician | $152.3K | $0 |
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