Quest Diagnostics Clinical Laboratories INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: 86258 at 2.3× median, 88263 at 1.0× 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
▼
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 $211.1M is at the 50th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$211.1M
$211,134,090
Total Claims
19.6M
Beneficiaries
17.4M
1.1 claims/patient
Avg Cost/Claim
$11
#418 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 Tucker, GA. From the 2018–2024 period, this provider received $211.1M in Medicaid payments across 19.6M claims.
Why This Matters
This provider received $211.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,391 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 13% of total spending.
$26.6M
354K claims
$75.12
$63.08
Infectious disease detection (COVID-19)
$26.6M
354K claims · 12.6%
$10.1M
356K claims
$28.49
$35.43
Drug test, presumptive, by chemistry analyzers
$10.1M
356K claims · 4.8%
$9.5M
547K claims
$17.37
$24.95
Chlamydia detection, nucleic acid, amplified probe
$9.5M
547K claims · 4.5%
$9.0M
539K claims
$16.77
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$9.0M
539K claims · 4.3%
General health panel
$7.4M
381K claims · 3.5%
Lipid panel
$7.2M
1.1M claims · 3.4%
$6.9M
234K claims
$29.65
$37.56
Drug test, definitive, 1-7 drug classes
$6.9M
234K claims · 3.3%
Vitamin D, 25 hydroxy
$6.2M
431K claims · 3.0%
Comprehensive metabolic panel
$6.1M
1.3M claims · 2.9%
$5.9M
157K claims
$37.75
$38.79
Infectious agent detection, amplified probe, multiple organisms
$5.9M
157K claims · 2.8%
Thyroid stimulating hormone (TSH)
$5.5M
695K claims · 2.6%
$4.1M
308K claims
$13.15
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$4.1M
308K claims · 1.9%
$3.7M
950K claims
$3.95
$4.71
Complete blood count (CBC) with differential, automated
$3.7M
950K claims · 1.8%
$3.7M
8K claims
$489.75
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$3.7M
8K claims · 1.8%
$3.5M
268K claims
$13.13
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$3.5M
268K claims · 1.7%
$3.3M
746K claims
$4.46
$5.50
Hemoglobin A1c (glycated hemoglobin)
$3.3M
746K claims · 1.6%
$2.8M
123K claims · 1.3%
CFTR gene analysis, common variants
$2.8M
8K claims · 1.3%
$2.8M
66K claims · 1.3%
$2.7M
601K claims
$4.54
$5.31
Urine culture, colony count, with identification
$2.7M
601K claims · 1.3%
$2.5M
178K claims
$14.26
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$2.5M
178K claims · 1.2%
$2.5M
121K claims
$20.80
$15.76
Infectious disease detection, COVID-19, antigen
$2.5M
121K claims · 1.2%
$2.4M
52K claims
$46.46
$40.67
Allergen specific IgE blood test, each allergen
$2.4M
52K claims · 1.2%
$2.3M
127K claims
$18.04
$25.57
HPV detection, high-risk types, nucleic acid
$2.3M
127K claims · 1.1%
$2.1M
66K claims
$31.03
$35.80
Surgical pathology, gross and microscopic examination
$2.1M
66K claims · 1.0%
$1.9M
404K claims · 0.9%
$1.8M
15K claims
$124.52
$97.61
Respiratory virus detection, 6-11 targets, nucleic acid
$1.8M
15K claims · 0.9%
Cyanocobalamin (vitamin B-12)
$1.8M
238K claims · 0.8%
$1.6M
76K claims · 0.8%
$1.6M
2K claims · 0.7%
Other Top Providers in Georgia
View all →Public Partnerships LLC
Supports Brokerage
$520.3M
Scottish Rite Children's Medical Center
Pediatrics Pediatric Hematology-Oncology
$493.4M
Egleston Children's Hospital at Emory University Inc.
Pediatrics Pediatric Emergency Medicine
$222.6M
Southern Home Care Services Inc.
Home Health
$212.2M
Normal Life of Georgia
Community/Behavioral Health
$165.1M
Similar Providers
Other top providers in Clinical Medical Laboratory