Northwell Health Laboratories
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 71 procedure codes: 88112 at 2.2× median, 88360 at 3.2× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
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:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
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
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
This provider's total spending of $198.2M is at the 50th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$198.2M
$198,238,416
Total Claims
10.6M
Beneficiaries
10.1M
1.1 claims/patient
Avg Cost/Claim
$19
#465 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Northwell Health Laboratories is a Clinical Medical Laboratory provider based in New Hyde Park, NY. From the 2018–2024 period, this provider received $198.2M in Medicaid payments across 10.6M claims.
Why This Matters
This provider received $198.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,779 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (87633 (Respiratory virus detection, 12-25 targets, nucleic acid)) accounts for 11% of total spending.
$21.3M
86K claims
$249.05
$169.17
Respiratory virus detection, 12-25 targets, nucleic acid
$21.3M
86K claims · 10.7%
$18.1M
245K claims
$73.67
$60.05
COVID-19 test, nucleic acid detection, CDC lab only
$18.1M
245K claims · 9.1%
$7.9M
105K claims
$74.56
$63.08
Infectious disease detection (COVID-19)
$7.9M
105K claims · 4.0%
Vitamin D, 25 hydroxy
$5.9M
247K claims · 3.0%
Comprehensive metabolic panel
$5.7M
659K claims · 2.9%
General health panel
$5.2M
120K claims · 2.6%
$5.1M
182K claims
$28.25
$24.95
Chlamydia detection, nucleic acid, amplified probe
$5.1M
182K claims · 2.6%
$5.1M
182K claims
$28.19
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$5.1M
182K claims · 2.6%
Lipid panel
$4.3M
430K claims · 2.2%
$4.2M
200K claims
$21.04
$15.76
Infectious disease detection, COVID-19, antigen
$4.2M
200K claims · 2.1%
$3.9M
49K claims
$80.16
$35.80
Surgical pathology, gross and microscopic examination
$3.9M
49K claims · 2.0%
$3.6M
340K claims
$10.70
$9.87
Thyroid stimulating hormone (TSH)
$3.6M
340K claims · 1.8%
$3.6M
82K claims
$44.28
$39.70
COVID-19 SARS-CoV-2 amplified probe detection
$3.6M
82K claims · 1.8%
$2.9M
23K claims
$128.07
$100.62
Respiratory virus detection, 3-5 targets, nucleic acid
$2.9M
23K claims · 1.5%
$2.8M
544K claims
$5.13
$4.71
Complete blood count (CBC) with differential, automated
$2.8M
544K claims · 1.4%
Antibody, SARS-CoV-2 (COVID-19)
$2.8M
72K claims · 1.4%
$2.7M
95K claims · 1.3%
$2.6M
95K claims · 1.3%
$2.6M
356K claims
$7.38
$5.50
Hemoglobin A1c (glycated hemoglobin)
$2.6M
356K claims · 1.3%
$2.4M
45K claims
$53.69
$38.35
Tuberculosis test, cell-mediated immunity
$2.4M
45K claims · 1.2%
Cyanocobalamin (vitamin B-12)
$2.3M
181K claims · 1.2%
$2.1M
50K claims
$42.67
$26.72
Infectious agent detection, nucleic acid, not otherwise specified
$2.1M
50K claims · 1.1%
CFTR gene analysis, common variants
$2.1M
6K claims · 1.0%
$1.9M
64K claims
$29.84
$25.57
HPV detection, high-risk types, nucleic acid
$1.9M
64K claims · 1.0%
$1.7M
69K claims
$25.32
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$1.7M
69K claims · 0.9%
$1.6M
21K claims · 0.8%
$1.5M
242K claims · 0.7%
$1.5M
204K claims
$7.22
$5.31
Urine culture, colony count, with identification
$1.5M
204K claims · 0.7%
$1.5M
184K claims · 0.7%
$1.4M
117K claims · 0.7%
Other Top Providers in New York
View all →Similar Providers
Other top providers in Clinical Medical Laboratory