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NPI 1124753249 · Chicago, IL · Clinical Medical Laboratory
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Sh Diagnostics Inc is a clinical medical laboratory provider located in Chicago, Illinois. This profile covers 5 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Sh Diagnostics Inc |
| Address | 3525 W Peterson Ave Ste 117 |
| City | Chicago |
| State | IL |
| ZIP | 60659 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 21, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.9M |
| Medicare | $4.5M |
This is a high-volume clinical diagnostic laboratory focused on SARS–CoV–2 and related respiratory testing: its Medicare top codes are 87637 (multiplex respiratory NAAT), 86328 (SARS–CoV–2 antibody immunoassay), and U0003 (high-throughput SARS–CoV–2 NAAT), and Medicaid top codes include 87913 (SARS–CoV–2 genotype sequencing) alongside 87637 and 86328. The specific code mix and presence of U0003 and 87913 indicate the operation performs large-scale molecular diagnostics and next-generation sequencing workflows rather than routine anatomic pathology or point-of-care testing.
Revenue is highly concentrated across a small set of tests for both payers: the precomputed top-3 Medicare codes account for 95.1% of this provider’s total Medicare revenue, and the precomputed top-3 Medicaid codes account for 100.0% of its total Medicaid revenue. For Medicare the provider’s total revenue is $4.5M and for Medicaid $5.9M, showing that virtually all billing is driven by a narrow set of COVID/respiratory-related panels and sequencing services.
Medicare competitive standing is unusually strong for select codes: 87637 generated $2.8M from 19.8K claims and ranks #8 of 1141 providers nationally, a 99th percentile placement described as an "extreme outlier" compared with peers. 86328 produced $871.5K from 19.8K claims and ranks #4 of 119 providers (97th percentile, "notably above typical"), while U0003 contributed $661.9K from 8.9K claims and is characterized as 97th percentile but "typical, unremarkable" volume for that code.
State-level Medicaid standing shows concentrated strength in sequencing and multiplex testing: 87913 produced $2.6M from 16.7K claims and ranks #5 of 10 in-state (56th percentile, "typical, unremarkable"), while 87637 produced $2.6M from 18.2K claims and ranks #5 of 79 in-state (95th percentile, "notably above typical" state volume). 86328 added $757.4K from 17.2K claims and ranks #2 of 26 in-state (96th percentile, "notably above typical"), so the provider is a major in-state player for antibody and multiplex respiratory testing.
Payer mix tilts modestly toward Medicaid by scale: reported lifetime Medicaid revenue is $5.9M versus $4.5M in Medicare, so Medicaid is the larger single payer in dollar terms for this entity. The provider is therefore not single-payer dependent, but its business is more heavily weighted toward the Medicaid side of its testing volume and revenue.
Operational footprint and throughput implications are clear from code-level volumes and code definitions: large claim counts (e.g., 19.8K claims for both 87637 and 86328 on Medicare) combined with use of U0003 (high-throughput amplified probe technique) and 87913 (next-generation sequencing) point to centralized, high-throughput laboratory capacity that handles both diagnostic NAAT panels and sequencing/genotyping services. This profile suggests significant instrument, automation, and logistics capability to process high specimen volumes.
Tenure on file is short relative to legacy labs: the NPI was enumerated on 2022-07-21 (~4 years ago), indicating the organization has operated under this NPI for a limited period while already achieving substantial volume in respiratory and SARS–CoV–2 testing. Rapid scaling to the volumes shown (multi-thousand claim counts and multimillion-dollar payer revenues) is consistent with a purpose-built COVID/respiratory testing lab model.
The mix of statistical labels across payers highlights exceptional concentration on a few high-impact codes: nationally the provider is an "extreme outlier" on 87637 and "notably above typical" on 86328, while in-state ranks for 87637 and 86328 are also described as "notably above typical". These descriptors, together with the precomputed concentration percentages, indicate dominance in a narrow set of services rather than broad-spectrum laboratory billing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 19,820 | $140 | $2.8M |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 19,810 | $40 | $871.5K |
| 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… | 8,950 | $70 | $661.9K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 8,960 | $20 | $206.1K |
| 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,… | 600 | $30 | $14.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87913 | Code 87913 describes genotype analysis using a specimen from a patient with confirmed severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) infection. The test uses next–generation sequencing… | 16,710 | $150 | $2.6M |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 18,210 | $140 | $2.6M |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 17,210 | $40 | $757.4K |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87913 | Code 87913 describes genotype analysis using a specimen from a patient with confirmed severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) infection. The test uses next–generation sequencing… | 5 | 10 | 16,610 | $150 | $2.9M |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 5 | 80 | 530 | $130 | $505.1K |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 2 | 30 | 110 | $40 | $95K |
Other providers in the same ZIP code as Sh Diagnostics Inc, ranked by combined Medicare and Medicaid revenue.
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