Quest Diagnostics Clinical Laboratories INC
Clinical Medical Laboratory
Miramar, Florida
NPI: 1518903350
Risk Tier
Critical
Total Paid
$197.6M
$197,582,867
Total Claims
24.3M
Beneficiaries
22.2M
Avg Cost/Claim
$8.12
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (3)
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.
Advanced Detection Signals
Billing Velocity
13172.0 claims per working day — may exceed physically possible volume for a single provider.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024