Quest Diagnostics Clinical Laboratories INC
Clinical Medical Laboratory
Irving, Texas
NPI: 1790721538
Risk Tier
Elevated
Total Paid
$276.8M
$276,762,745
Total Claims
26.9M
Beneficiaries
24.8M
Avg Cost/Claim
$10.28
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
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.
Advanced Detection Signals
Billing Velocity
14562.1 claims per working day — may exceed physically possible volume for a single provider.
CUSUM Change Point
Billing shifted 4.6x in 2020-10 — a statistically significant structural change in billing behavior was detected.
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