Is LABTOX, LLC flagged for Medicaid fraud?

LABTOX, LLC (NPI: 1235576398) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does LABTOX, LLC bill Medicaid?

LABTOX, LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinical Medical Laboratory provider. Located in LEXINGTON, KY.

What is NPI 1235576398?

NPI 1235576398 is the National Provider Identifier for LABTOX, LLC. They are a Clinical Medical Laboratory provider based in LEXINGTON, KY. This NPI is registered with the CMS NPI Registry.

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LABTOX, LLC

Clinical Medical Laboratory·LEXINGTON, KY·NPI: 1235576398Share

Compared to Clinical Medical Laboratory Peers

Total spending distribution among 88 providers in this specialty

P25MedianP75P90

This provider's total spending of $21.8M is at the 25th percentile among 88 Clinical Medical Laboratory providers.

Active Billing Period:2018-01→2023-08(68 months)

Billing appears to have stoppedLast active: 2023-08

Total Paid

$21.8M

$21,754,964

Total Claims

464K

Beneficiaries

150K

3.1 claims/patient

Avg Cost/Claim

$47

Monthly Spending Trend

Yearly Spending

2018

$5.0M

+34%

2019

$6.7M

-30%

2020

$4.7M

-44%

2021

$2.6M

-33%

2022

$1.7M

-38%

2023

$1.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (G0483 (Drug test, definitive, 22+ drug classes)) accounts for 71% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

G0483Drug test, definitive, 22+ drug classesSee all providers →

$15.4M

198K claims

$77.73

$90.89

0.9×

Normal range

G0483Normal range

Drug test, definitive, 22+ drug classes

$15.4M

198K claims · 70.8%

Your Cost: $77.73/claim|Median: $90.89

0.9× median

80307Drug test, presumptive, by chemistry analyzersSee all providers →

$4.9M

220K claims

$22.17

$35.43

0.6×

Normal range

80307Normal range

Drug test, presumptive, by chemistry analyzers

$4.9M

220K claims · 22.4%

Your Cost: $22.17/claim|Median: $35.43

0.6× median

G0482Drug test, definitive, 15-21 drug classesSee all providers →

$650K

12K claims

$56.38

$75.26

0.7×

Normal range

G0482Normal range

Drug test, definitive, 15-21 drug classes

$650K

12K claims · 3.0%

Your Cost: $56.38/claim|Median: $75.26

0.7× median

G0480Drug test, definitive, 1-7 drug classesSee all providers →

$402K

13K claims

$31.39

$37.56

0.8×

Normal range

G0480Normal range

Drug test, definitive, 1-7 drug classes

$402K

13K claims · 1.8%

Your Cost: $31.39/claim|Median: $37.56

0.8× median

U0003Infectious disease detection (COVID-19)See all providers →

$341K

11K claims

$30.98

$63.08

0.5×

Normal range

U0003Normal range

Infectious disease detection (COVID-19)

$341K

11K claims · 1.6%

Your Cost: $30.98/claim|Median: $63.08

0.5× median

U0005Infectious disease detection, COVID-19, antigenSee all providers →

$79K

8,422 claims

$9.41

$15.76

0.6×

Normal range

U0005Normal range

Infectious disease detection, COVID-19, antigen

$79K

8,422 claims · 0.4%

Your Cost: $9.41/claim|Median: $15.76

0.6× median

G0481Drug test, definitive, 8-14 drug classesSee all providers →

$5K

206 claims

$24.68

$64.72

0.4×

Normal range

G0481Normal range

Drug test, definitive, 8-14 drug classes

$5K

206 claims · 0.0%

Your Cost: $24.68/claim|Median: $64.72

0.4× median

87811SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-readSee all providers →

$4K

257 claims

$14.25

$30.53

0.5×

Normal range

87811Normal range

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$4K

257 claims · 0.0%

Your Cost: $14.25/claim|Median: $30.53

0.5× median

G2023Specimen collection for COVID-19 testingSee all providers →

$2K

283 claims

$8.15

$17.15

0.5×

Normal range

G2023Normal range

Specimen collection for COVID-19 testing

$2K

283 claims · 0.0%

Your Cost: $8.15/claim|Median: $17.15

0.5× median

87635COVID-19 SARS-CoV-2 amplified probe detectionSee all providers →

$773

41 claims

$18.86

$39.70

0.5×

Normal range

87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$773

41 claims · 0.0%

Your Cost: $18.86/claim|Median: $39.70

0.5× median

P9604 See all providers →

$81

1,181 claims

$0.07

$0.81

0.1×

Normal range

P9604Normal range

$81

1,181 claims · 0.0%

Your Cost: $0.07/claim|Median: $0.81

0.1× median

87426SARS-CoV-2 COVID-19 antigen detection, immunoassaySee all providers →

853 claims

$0.00

$30.04

—

Normal range

87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

853 claims · 0.0%

Your Cost: $0.00/claim|Median: $30.04

87631Respiratory virus detection, 3-5 targets, multiplexSee all providers →

24 claims

$0.00

$65.45

—

Normal range

87631Normal range

Respiratory virus detection, 3-5 targets, multiplex

24 claims · 0.0%

Your Cost: $0.00/claim|Median: $65.45

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