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

Sonora Quest Laboratories LLC

Clinical Medical Laboratory·Phoenix, AZ·NPI: 1538105366SharePrint 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:

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

Billing Velocity15419.4 claims/working day

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 $298.1M is at the 75th percentile among 88 Clinical Medical Laboratory providers.

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

Total Paid

$298.1M

$298,054,861

Total Claims

28.5M

Beneficiaries

26.0M

1.1 claims/patient

Avg Cost/Claim

$10

#250 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Sonora Quest Laboratories LLC is a Clinical Medical Laboratory provider based in Phoenix, AZ. From the 2018–2024 period, this provider received $298.1M in Medicaid payments across 28.5M claims.

Why This Matters

This provider received $298.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 37,256 Medicaid beneficiaries for a full year at average per-enrollee costs.

16% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$28.7M
+22%
2019
$34.9M
+32%
2020
$46.2M
+50%
2021
$69.3M
-26%
2022
$51.2M
-33%
2023
$34.5M
-3%
2024
$33.4M

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 27% of total spending.

U0003Top 25%

Infectious disease detection (COVID-19)

$80.1M

882K claims · 26.9%

Your Cost: $90.75/claim|Median: $63.08
1.4× median
G0480Normal range

Drug test, definitive, 1-7 drug classes

$16.3M

350K claims · 5.5%

Your Cost: $46.61/claim|Median: $37.56
1.2× median
80050Normal range

General health panel

$15.3M

1.1M claims · 5.1%

Your Cost: $13.41/claim|Median: $25.59
0.5× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$14.1M

474K claims · 4.7%

Your Cost: $29.74/claim|Median: $35.43
0.8× median
87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$9.5M

594K claims · 3.2%

Your Cost: $15.93/claim|Median: $24.95
0.6× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$9.4M

593K claims · 3.1%

Your Cost: $15.81/claim|Median: $23.39
0.7× median
80061Normal range

Lipid panel

$9.3M

1.5M claims · 3.1%

Your Cost: $6.24/claim|Median: $8.41
0.7× median
82306Normal range

Vitamin D, 25 hydroxy

$8.5M

758K claims · 2.8%

Your Cost: $11.17/claim|Median: $18.18
0.6× median
80053Normal range

Comprehensive metabolic panel

$6.4M

1.7M claims · 2.1%

Your Cost: $3.82/claim|Median: $7.24
0.5× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$5.6M

1.2M claims · 1.9%

Your Cost: $4.52/claim|Median: $5.50
0.8× median
88175Normal range

Cytopathology, cervical or vaginal, ThinPrep

$4.9M

248K claims · 1.6%

Your Cost: $19.77/claim|Median: $19.06
1.0× median
85025Normal range

Complete blood count (CBC) with differential, automated

$4.3M

1.7M claims · 1.4%

Your Cost: $2.49/claim|Median: $4.71
0.5× median
84443Normal range

Thyroid stimulating hormone (TSH)

$3.9M

665K claims · 1.3%

Your Cost: $5.91/claim|Median: $9.87
0.6× median
87389Normal range

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

$3.4M

283K claims · 1.2%

Your Cost: $12.12/claim|Median: $18.03
0.7× median
88305Normal range

Surgical pathology, gross and microscopic examination

$3.2M

96K claims · 1.1%

Your Cost: $33.46/claim|Median: $35.80
0.9× median
87661Normal range

Trichomonas vaginalis detection, nucleic acid, amplified probe

$3.1M

208K claims · 1.0%

Your Cost: $14.99/claim|Median: $21.08
0.7× median
87799Top 25%

$3.0M

70K claims · 1.0%

Your Cost: $42.35/claim|Median: $21.87
1.9× median
36415Normal range

Collection of venous blood by venipuncture

$2.7M

1.8M claims · 0.9%

Your Cost: $1.53/claim|Median: $1.57
1.0× median
87624Normal range

HPV detection, high-risk types, nucleic acid

$2.6M

167K claims · 0.9%

Your Cost: $15.79/claim|Median: $25.57
0.6× median
82607Normal range

Cyanocobalamin (vitamin B-12)

$2.6M

375K claims · 0.9%

Your Cost: $7.03/claim|Median: $8.72
0.8× median
80081Normal range

$2.6M

80K claims · 0.9%

Your Cost: $32.12/claim|Median: $59.44
0.5× median
86003Normal range

Allergen specific IgE blood test, each allergen

$2.2M

65K claims · 0.7%

Your Cost: $34.16/claim|Median: $40.67
0.8× median
87086Normal range

Urine culture, colony count, with identification

$2.1M

647K claims · 0.7%

Your Cost: $3.30/claim|Median: $5.31
0.6× median
80074Normal range

$2.1M

101K claims · 0.7%

Your Cost: $20.35/claim|Median: $27.54
0.7× median
84439Normal range

Free thyroxine level blood test

$1.9M

455K claims · 0.6%

Your Cost: $4.23/claim|Median: $6.31
0.7× median
81513Normal range

$1.8M

26K claims · 0.6%

Your Cost: $68.05/claim|Median: $71.32
0.9× median
82746Normal range

$1.7M

248K claims · 0.6%

Your Cost: $6.92/claim|Median: $6.83
1.0× median
86803Normal range

Hepatitis C antibody

$1.7M

226K claims · 0.6%

Your Cost: $7.48/claim|Median: $10.17
0.7× median
87801Normal range

Infectious agent detection, amplified probe, multiple organisms

$1.7M

48K claims · 0.6%

Your Cost: $35.19/claim|Median: $38.79
0.9× median
86769Top 25%

Antibody, SARS-CoV-2 (COVID-19)

$1.6M

44K claims · 0.5%

Your Cost: $36.60/claim|Median: $26.94
1.4× median