Quest Diagnostics Massachusetts LLC
Clinical Medical Laboratory
Marlborough, Massachusetts
NPI: 1194062448
Risk Tier
Elevated
Total Paid
$199.9M
$199,858,547
Total Claims
17.5M
Beneficiaries
16.3M
Avg Cost/Claim
$11.44
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 12 procedure codes: 0241U at 3.5× median, 81511 at 4.1× median.
Advanced Detection Signals
Billing Velocity
9454.5 claims per working day — may exceed physically possible volume for a single provider.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024