Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Quest Diagnostics Incorporated MD

Clinical Medical Laboratory·Baltimore, MD·NPI: 1245307818SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Billing Velocity4511.8 claims/working day
Change PointBilling shifted 3.2x in 2020-06

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Compared to Clinical Medical Laboratory Peers

Total spending distribution among 88 providers in this specialty

P25MedianP75P90

This provider's total spending of $121.8M is at the 25th percentile among 88 Clinical Medical Laboratory providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$121.8M

$121,814,555

Total Claims

8.3M

Beneficiaries

7.4M

1.1 claims/patient

Avg Cost/Claim

$15

#979 of 618K providers by total spending(top 0.2%)

🔍 Analysis

Provider Overview

Quest Diagnostics Incorporated MD is a Clinical Medical Laboratory provider based in Baltimore, MD. From the 2018–2024 period, this provider received $121.8M in Medicaid payments across 8.3M claims.

Why This Matters

This provider received $121.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,226 Medicaid beneficiaries for a full year at average per-enrollee costs.

109% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$6.8M
-27%
2019
$5.0M
+292%
2020
$19.4M
+66%
2021
$32.1M
-15%
2022
$27.2M
-37%
2023
$17.2M
-18%
2024
$14.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (U0003 (Infectious disease detection (COVID-19))) accounts for 24% of total spending.

U0003Top 25%

Infectious disease detection (COVID-19)

$29.3M

376K claims · 24.1%

Your Cost: $77.86/claim|Median: $63.08
1.2× median
G0480Top 25%

Drug test, definitive, 1-7 drug classes

$7.3M

94K claims · 6.0%

Your Cost: $78.25/claim|Median: $37.56
2.1× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$6.9M

148K claims · 5.7%

Your Cost: $46.55/claim|Median: $35.43
1.3× median
87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$5.4M

239K claims · 4.4%

Your Cost: $22.54/claim|Median: $24.95
0.9× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$5.3M

239K claims · 4.4%

Your Cost: $22.24/claim|Median: $23.39
0.9× median
80061Normal range

Lipid panel

$3.3M

447K claims · 2.7%

Your Cost: $7.42/claim|Median: $8.41
0.9× median
80053Normal range

Comprehensive metabolic panel

$3.0M

499K claims · 2.5%

Your Cost: $6.05/claim|Median: $7.24
0.8× median
82306Normal range

Vitamin D, 25 hydroxy

$2.8M

193K claims · 2.3%

Your Cost: $14.64/claim|Median: $18.18
0.8× median
87389Normal range

HIV-1 antigen with HIV-1 and HIV-2 antibodies

$2.7M

184K claims · 2.2%

Your Cost: $14.68/claim|Median: $18.03
0.8× median
G0481Top 25%

Drug test, definitive, 8-14 drug classes

$2.7M

22K claims · 2.2%

Your Cost: $120.34/claim|Median: $64.72
1.9× median
84443Normal range

Thyroid stimulating hormone (TSH)

$2.3M

258K claims · 1.9%

Your Cost: $8.94/claim|Median: $9.87
0.9× median
85025Normal range

Complete blood count (CBC) with differential, automated

$2.1M

472K claims · 1.7%

Your Cost: $4.48/claim|Median: $4.71
0.9× median
87801Normal range

Infectious agent detection, amplified probe, multiple organisms

$1.9M

46K claims · 1.6%

Your Cost: $41.15/claim|Median: $38.79
1.1× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$1.8M

352K claims · 1.5%

Your Cost: $5.09/claim|Median: $5.50
0.9× median
87661Normal range

Trichomonas vaginalis detection, nucleic acid, amplified probe

$1.7M

93K claims · 1.4%

Your Cost: $17.81/claim|Median: $21.08
0.8× median
86480Normal range

Tuberculosis test, cell-mediated immunity

$1.6M

50K claims · 1.4%

Your Cost: $33.19/claim|Median: $38.35
0.9× median
81420Normal range

Fetal chromosomal aneuploidy genomic sequence analysis

$1.6M

4K claims · 1.4%

Your Cost: $384.23/claim|Median: $358.21
1.1× median
88175Normal range

Cytopathology, cervical or vaginal, ThinPrep

$1.5M

90K claims · 1.2%

Your Cost: $16.22/claim|Median: $19.06
0.8× median
U0005Normal range

Infectious disease detection, COVID-19, antigen

$1.4M

90K claims · 1.2%

Your Cost: $15.61/claim|Median: $15.76
1.0× median
81220Normal range

CFTR gene analysis, common variants

$1.4M

6K claims · 1.1%

Your Cost: $214.84/claim|Median: $183.31
1.2× median
87624Normal range

HPV detection, high-risk types, nucleic acid

$1.2M

55K claims · 1.0%

Your Cost: $21.97/claim|Median: $25.57
0.9× median
87536Normal range

$1.1M

25K claims · 0.9%

Your Cost: $44.91/claim|Median: $51.73
0.9× median
87799Normal range

$1.1M

48K claims · 0.9%

Your Cost: $22.70/claim|Median: $21.87
1.0× median
87636Top 25%

Respiratory virus detection, 6-11 targets, nucleic acid

$1.1M

8K claims · 0.9%

Your Cost: $129.90/claim|Median: $97.61
1.3× median
86803Normal range

Hepatitis C antibody

$1.0M

120K claims · 0.9%

Your Cost: $8.69/claim|Median: $10.17
0.8× median
80081Normal range

$999K

21K claims · 0.8%

Your Cost: $48.56/claim|Median: $59.44
0.8× median
87633Normal range

Respiratory virus detection, 12-25 targets, nucleic acid

$907K

5K claims · 0.7%

Your Cost: $172.95/claim|Median: $169.17
1.0× median
81513Normal range

$875K

24K claims · 0.7%

Your Cost: $36.45/claim|Median: $71.32
0.5× median
88305Top 25%

Surgical pathology, gross and microscopic examination

$834K

14K claims · 0.7%

Your Cost: $61.18/claim|Median: $35.80
1.7× median
80050Normal range

General health panel

$771K

98K claims · 0.6%

Your Cost: $7.87/claim|Median: $25.59
0.3× median