Quest Diagnostics Clinical Laboratories INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 5 procedure codes: 88307 at 4.2× median, 87641 at 2.7× 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
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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 $276.8M is at the 75th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$276.8M
$276,762,745
Total Claims
26.9M
Beneficiaries
24.8M
1.1 claims/patient
Avg Cost/Claim
$10
#282 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Quest Diagnostics Clinical Laboratories INC is a Clinical Medical Laboratory provider based in Irving, TX. From the 2018–2024 period, this provider received $276.8M in Medicaid payments across 26.9M claims.
Why This Matters
This provider received $276.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 34,595 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 (U0003 (Infectious disease detection (COVID-19))) accounts for 18% of total spending.
$48.6M
692K claims
$70.21
$63.08
Infectious disease detection (COVID-19)
$48.6M
692K claims · 17.6%
$13.4M
703K claims
$18.99
$24.95
Chlamydia detection, nucleic acid, amplified probe
$13.4M
703K claims · 4.8%
General health panel
$13.3M
618K claims · 4.8%
$13.1M
700K claims
$18.73
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$13.1M
700K claims · 4.7%
$8.7M
406K claims
$21.47
$15.76
Infectious disease detection, COVID-19, antigen
$8.7M
406K claims · 3.2%
Lipid panel
$8.3M
1.4M claims · 3.0%
Vitamin D, 25 hydroxy
$7.2M
574K claims · 2.6%
$7.0M
238K claims
$29.52
$35.43
Drug test, presumptive, by chemistry analyzers
$7.0M
238K claims · 2.5%
$6.5M
550K claims
$11.79
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$6.5M
550K claims · 2.3%
$6.4M
19K claims
$342.18
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$6.4M
19K claims · 2.3%
Comprehensive metabolic panel
$5.8M
1.3M claims · 2.1%
$5.1M
389K claims · 1.8%
$5.0M
304K claims
$16.58
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$5.0M
304K claims · 1.8%
Thyroid stimulating hormone (TSH)
$5.0M
769K claims · 1.8%
$4.8M
82K claims · 1.8%
$4.6M
126K claims
$36.67
$38.79
Infectious agent detection, amplified probe, multiple organisms
$4.6M
126K claims · 1.7%
$4.6M
1.1M claims
$4.18
$5.50
Hemoglobin A1c (glycated hemoglobin)
$4.6M
1.1M claims · 1.7%
$4.4M
107K claims · 1.6%
$4.2M
1.4M claims
$3.13
$4.71
Complete blood count (CBC) with differential, automated
$4.2M
1.4M claims · 1.5%
$3.8M
19K claims
$197.61
$183.31
CFTR gene analysis, common variants
$3.8M
19K claims · 1.4%
$3.6M
100K claims
$36.61
$37.56
Drug test, definitive, 1-7 drug classes
$3.6M
100K claims · 1.3%
$3.6M
249K claims
$14.34
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$3.6M
249K claims · 1.3%
$2.8M
150K claims
$18.86
$25.57
HPV detection, high-risk types, nucleic acid
$2.8M
150K claims · 1.0%
$2.7M
707K claims
$3.89
$5.31
Urine culture, colony count, with identification
$2.7M
707K claims · 1.0%
$2.4M
99K claims · 0.9%
$2.0M
531K claims · 0.7%
Hepatitis C antibody
$1.9M
280K claims · 0.7%
$1.8M
444K claims · 0.7%
$1.8M
58K claims
$30.83
$38.35
Tuberculosis test, cell-mediated immunity
$1.8M
58K claims · 0.7%
$1.7M
12K claims
$138.89
$169.17
Respiratory virus detection, 12-25 targets, nucleic acid
$1.7M
12K claims · 0.6%
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