Is GENOMIC HEALTH, INC. flagged for Medicaid fraud?

GENOMIC HEALTH, INC. (NPI: 1215003603) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does GENOMIC HEALTH, INC. bill Medicaid?

GENOMIC HEALTH, INC. received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinical Medical Laboratory provider. Located in REDWOOD CITY, CA.

What is NPI 1215003603?

NPI 1215003603 is the National Provider Identifier for GENOMIC HEALTH, INC.. They are a Clinical Medical Laboratory provider based in REDWOOD CITY, CA. This NPI is registered with the CMS NPI Registry.

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GENOMIC HEALTH, INC.

Clinical Medical Laboratory·REDWOOD CITY, CA·NPI: 1215003603Share

Compared to Clinical Medical Laboratory Peers

Total spending distribution among 88 providers in this specialty

P25MedianP75P90

This provider's total spending of $96.6M is at the 25th percentile among 88 Clinical Medical Laboratory providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$96.6M

$96,562,595

Total Claims

49K

Beneficiaries

44K

1.1 claims/patient

Avg Cost/Claim

$2K

Monthly Spending Trend

Yearly Spending

2018

$8.9M

+23%

2019

$10.9M

+5%

2020

$11.5M

+35%

2021

$15.6M

+13%

2022

$17.6M

+8%

2023

$19.0M

-30%

2024

$13.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 8 distinct procedure codes. The top code (81519) accounts for 99% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

81519 See all providers →

$95.8M

46K claims

$2,073.30

1.0×

Normal range

81519Normal range

$95.8M

46K claims · 99.2%

Your Cost: $2,073.30/claim|Median: $2,073.30

1.0× median

0047U See all providers →

$242K

393 claims

$614.60

$589.81

1.0×

Top 1%

0047UTop 1%

$242K

393 claims · 0.3%

Your Cost: $614.60/claim|Median: $589.81

1.0× median

0244U See all providers →

$190K

316 claims

$602.29

1.0×

Normal range

0244UNormal range

$190K

316 claims · 0.2%

Your Cost: $602.29/claim|Median: $602.29

1.0× median

81479Unlisted molecular pathology procedureSee all providers →

$165K

824 claims

$200.19

$38.66

5.2×

Top 25%

81479Top 25%

Unlisted molecular pathology procedure

$165K

824 claims · 0.2%

Your Cost: $200.19/claim|Median: $38.66

5.2× median

84999 See all providers →

$102K

377 claims

$270.37

$5.23

51.7×

Top 5%

84999Top 5%

$102K

377 claims · 0.1%

Your Cost: $270.37/claim|Median: $5.23

51.7× median

88360 See all providers →

$99K

680 claims

$144.98

$40.50

3.6×

Top 10%

88360Top 10%

$99K

680 claims · 0.1%

Your Cost: $144.98/claim|Median: $40.50

3.6× median

81525 See all providers →

$10K

30 claims

$319.00

1.0×

Top 1%

81525Top 1%

$10K

30 claims · 0.0%

Your Cost: $319.00/claim|Median: $319.00

1.0× median

81599 See all providers →

$3K

233 claims

$11.14

$39.21

0.3×

Normal range

81599Normal range

$3K

233 claims · 0.0%

Your Cost: $11.14/claim|Median: $39.21

0.3× median

Other Top Providers in California

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Los Angeles County Department of Mental Health

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$6.78B

County of Santa Clara

Community/Behavioral Health

$1.73B

County of Riverside

Community/Behavioral Health

$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

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