Quest Diagnostics Clinical Laboratories INC
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $2.0M (2018) to $22.4M (2019) — a 1041% swing with $20.4M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 9 procedure codes: 82085 at 2.8× median, 88313 at 8.6× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1041% from 2018 to 2019.
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:
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.
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.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
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 $197.6M is at the 50th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$197.6M
$197,582,867
Total Claims
24.3M
Beneficiaries
22.2M
1.1 claims/patient
Avg Cost/Claim
$8
#467 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 Miramar, FL. From the 2018–2024 period, this provider received $197.6M in Medicaid payments across 24.3M claims.
Why This Matters
This provider received $197.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,697 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 (87491 (Chlamydia detection, nucleic acid, amplified probe)) accounts for 6% of total spending.
$11.5M
678K claims
$16.95
$24.95
Chlamydia detection, nucleic acid, amplified probe
$11.5M
678K claims · 5.8%
$10.9M
135K claims
$80.82
$63.08
Infectious disease detection (COVID-19)
$10.9M
135K claims · 5.5%
$10.7M
30K claims
$358.21
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$10.7M
30K claims · 5.4%
Lipid panel
$9.4M
1.5M claims · 4.8%
$7.1M
27K claims
$262.41
$183.31
CFTR gene analysis, common variants
$7.1M
27K claims · 3.6%
$7.0M
671K claims
$10.51
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$7.0M
671K claims · 3.6%
Vitamin D, 25 hydroxy
$6.6M
507K claims · 3.3%
Thyroid stimulating hormone (TSH)
$6.1M
1.1M claims · 3.1%
Comprehensive metabolic panel
$5.6M
1.7M claims · 2.8%
$5.1M
973K claims
$5.21
$5.50
Hemoglobin A1c (glycated hemoglobin)
$5.1M
973K claims · 2.6%
$4.5M
98K claims
$45.83
$40.67
Allergen specific IgE blood test, each allergen
$4.5M
98K claims · 2.3%
$4.3M
1.6M claims
$2.61
$4.71
Complete blood count (CBC) with differential, automated
$4.3M
1.6M claims · 2.2%
$4.1M
474K claims
$8.76
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$4.1M
474K claims · 2.1%
$3.5M
200K claims
$17.33
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$3.5M
200K claims · 1.8%
$3.4M
116K claims
$29.60
$35.43
Drug test, presumptive, by chemistry analyzers
$3.4M
116K claims · 1.7%
$3.0M
168K claims
$18.12
$25.57
HPV detection, high-risk types, nucleic acid
$3.0M
168K claims · 1.5%
$2.8M
71K claims
$39.74
$38.79
Infectious agent detection, amplified probe, multiple organisms
$2.8M
71K claims · 1.4%
$2.7M
150K claims
$17.90
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$2.7M
150K claims · 1.4%
$2.6M
577K claims
$4.52
$5.31
Urine culture, colony count, with identification
$2.6M
577K claims · 1.3%
$2.5M
353K claims · 1.3%
General health panel
$2.5M
216K claims · 1.3%
Free thyroxine level blood test
$2.4M
490K claims · 1.2%
Ferritin
$2.2M
247K claims · 1.1%
$2.2M
6K claims · 1.1%
$1.8M
67K claims · 0.9%
Hepatitis C antibody
$1.8M
266K claims · 0.9%
$1.8M
236K claims · 0.9%
$1.8M
31K claims
$55.94
$35.80
Surgical pathology, gross and microscopic examination
$1.8M
31K claims · 0.9%
$1.7M
19K claims
$92.06
$97.61
Respiratory virus detection, 6-11 targets, nucleic acid
$1.7M
19K claims · 0.9%
$1.6M
65K claims · 0.8%
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