Lab
Carenexa, LLC
Carenexa, LLC was paid $26.31M by Medicaid between Jan 2018 and Dec 2024, across 75 billing codes. Its largest line is G0481, Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed — 29% of everything it billed.
33Billing provider infoCARENEXA, LLC
VANCOUVER, WA 98684
VANCOUVER, WA 98684
33aNPI1790021517assigned 12/26/2012
33bProvider typeClinical Medical Laboratory
28Total paid$26.31M
24GClaims504,059
24DCodes billed75
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in Washington
Rank by total paid#8 of 76
Median peer was paid$90K
This provider vs. median291×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 81,242 | $4.30M | |
| 2019 | 72,458 | $3.44M | |
| 2020 | 105,663 | $5.93M | |
| 2021 | 85,827 | $4.32M | |
| 2022 | 61,878 | $3.24M | |
| 2023 | 56,815 | $2.73M | |
| 2024incomplete | 40,176 | $2.35M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 29% | 110,068 | 72,257 | $7.61M |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 24% | 99,916 | 56,769 | $6.27M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 17% | 113,620 | 59,862 | $4.56M |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 16% | 66,411 | 25,641 | $4.18M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | 5.3% | 17,102 | 14,217 | $1.39M |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | 3.7% | 7,535 | 6,428 | $961K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 1.3% | 2,326 | 1,504 | $345K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 3,498 | 3,191 | $116K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 3,488 | 3,188 | $113K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 6,158 | 5,901 | $79K |
| 81226 | <1% | 310 | 280 | $68K | |
| 87522 | Neg quan hep c or qual rna | <1% | 2,707 | 2,518 | $63K |
63 more codes
| 81479 | Unlisted molecular pathology procedure | <1% | 381 | $59K |
| 81225 | <1% | 298 | $44K | |
| 86780 | <1% | 5,293 | $40K | |
| 86803 | <1% | 4,418 | $35K | |
| 87640 | <1% | 1,562 | $32K | |
| 87481 | <1% | 1,572 | $32K | |
| 87653 | <1% | 1,432 | $31K | |
| 81227 | <1% | 312 | $27K | |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 2,333 | $26K |
| 87340 | <1% | 4,446 | $25K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 1,642 | $25K |
| 81381 | <1% | 314 | $20K | |
| 81231 | <1% | 313 | $10K | |
| 80365 | <1% | 2,495 | $8K | |
| 80362 | <1% | 3,847 | $8K | |
| 80354 | <1% | 1,225 | $7K | |
| 80361 | <1% | 2,294 | $7K | |
| 80324 | <1% | 1,753 | $7K | |
| 80346 | <1% | 1,664 | $6K | |
| 82565 | <1% | 895 | $6K | |
| 80349 | <1% | 801 | $6K | |
| 80348 | <1% | 2,316 | $6K | |
| 86704 | <1% | 804 | $5K | |
| 80358 | <1% | 950 | $5K | |
| 80356 | <1% | 700 | $4K | |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 84 | $4K |
| 81401 | <1% | 125 | $4K | |
| 81291 | <1% | 163 | $4K | |
| 80355 | <1% | 2,144 | $3K | |
| 81355 | <1% | 39 | $3K | |
| 80366 | <1% | 2,189 | $3K | |
| 80321 | <1% | 748 | $3K | |
| 80359 | <1% | 537 | $3K | |
| 80353 | <1% | 532 | $3K | |
| 80372 | <1% | 1,838 | $3K | |
| 80367 | <1% | 413 | $3K | |
| 80373 | <1% | 723 | $2K | |
| 80357 | <1% | 164 | $2K | |
| 80369 | <1% | 2,706 | $2K | |
| 80345 | <1% | 396 | $2K | |
| 81230 | <1% | 39 | $2K | |
| 81328 | <1% | 39 | $2K | |
| 80335 | <1% | 126 | $1K | |
| 80332 | <1% | 2,564 | $1K | |
| 80368 | <1% | 2,496 | $1K | |
| 83992 | <1% | 142 | $1K | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 114 | $994.37 |
| 80350 | <1% | 1,547 | $895.14 | |
| 87486 | <1% | 116 | $882.12 | |
| 87581 | <1% | 116 | $882.12 | |
| 80363 | <1% | 104 | $791.16 | |
| 80360 | <1% | 1,646 | $635.96 | |
| 80371 | <1% | 1,550 | $535.26 | |
| 80338 | <1% | 1,040 | $531.23 | |
| 80375 | <1% | 820 | $451.23 | |
| 80323 | <1% | 693 | $267.05 | |
| 80370 | <1% | 217 | $250.93 | |
| 80337 | <1% | 215 | $225.48 | |
| 87500 | <1% | 16 | $217.73 | |
| 80334 | <1% | 220 | $196.56 | |
| 87511 | <1% | 27 | $135.22 | |
| 80364 | <1% | 180 | $66.94 | |
| 80374 | <1% | 32 | $20.20 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialHURST-WALL, RENE (SENIOR MANAGER PAYOR RELATIONS)
| Provider | Location | Paid |
|---|---|---|
| Carenexa, LLC | Irving, TX | $15K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.