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NPI 1194449330 · Hoffman Estates, IL · Clinical Medical Laboratory
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Medcare Laboratory Incorporated is a clinical medical laboratory provider located in Hoffman Estates, Illinois. This profile covers 1 Medicare and 1 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 | Medcare Laboratory Incorporated |
| Address | 1800 Mcdonough Rd Ste 201 |
| City | Hoffman Estates |
| State | IL |
| ZIP | 60192 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 30, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $17.1M |
| Medicaid | $1.9K |
MEDCARE LABORATORY INCORPORATED’s billed activity is overwhelmingly concentrated in a single service line: the provision of nonprescription self‑administered and self‑collected COVID‑19 tests as captured by code K1034. The code description and the claim profile indicate an operation oriented to high‑volume provision/distribution of over‑the‑counter COVID tests rather than diverse clinical laboratory testing services.
Revenue concentration is extreme on both payers: precomputed data indicate the top 3 Medicare codes account for 100.0% of the provider's total Medicare revenue and the top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue. This level of concentration implies virtually all reimbursed activity is attributable to the same narrow code set rather than a broader lab portfolio.
Medicare dominates this provider’s payer mix in scale: lifetime Medicare revenue is listed as $17.1M versus lifetime Medicaid revenue of $1.9K, so the business is effectively single‑payer with Medicare accounting for virtually all reported revenue. Medicaid activity is negligible by comparison and does not materially contribute to overall revenue.
The claims and reimbursement profile shows extremely high Medicare volume at low per‑claim payment: K1034 is reported with 1.5M claims and $12 avg paid/claim on the Medicare side, while Medicaid shows 965 claims at $2 avg paid/claim for the same code. This pattern (very large claim counts with low per‑claim payments) is consistent with a high‑throughput, low‑margin distribution model for OTC COVID tests rather than fee‑for‑service clinical testing.
Competitive standing for K1034 on Medicare is notable: K1034 generates $17.4M revenue for this provider and the record ranks the provider #23 of 30143 nationally (100th percentile; extreme outlier, far above typical national volume for this code). Put simply, this entity is a nationally prominent outlier for this specific COVID test code and represents a major national volume source for K1034.
By contrast, the provider’s Medicaid footprint for K1034 is modest in the state: the code generates $1.9K in Medicaid revenue, ranking #24 of 59 providers in‑state (60th percentile; typical, unremarkable volume). Medicaid billing is small and falls in the middle of in‑state peers for this code, so the provider is not a standout in state Medicaid markets.
The provider’s NPI was enumerated on 2022-09-30 (~4 years ago), indicating a relatively recent enrollment date relative to the very large Medicare claim volumes reported. The combination of a recent start date and rapid accumulation of high national volume suggests fast scale‑up focused on the K1034 service line.
There is a data inconsistency worth flagging for analyst follow‑up: the K1034 line item is shown with $17.4M revenue while the provider's listed lifetime Medicare revenue is $17.1M, even as K1034 is reported to represent 100.0% of Medicare revenue. Given the provider's extreme outlier status on Medicare, analysts should verify claim attribution, reimbursement mapping, and payer adjudication details before drawing operational or contracting conclusions.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,451,420 | $10 | $17.4M |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 9 | 1,150 | 720 | $10 | $414.9K |
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 970 | $1 | $1.9K |
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
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 24 | 60 | 660 | $1 | $3.2K |
Other providers in the same ZIP code as Medcare Laboratory Incorporated, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| James Quertermous | IL | MOHS-Micrographic Surgery Physician | $642.4K | $0 |
| Leslie Beaird | IL | Dermatology Physician | $437K | $8.2K |
| Melody Lee | IL | Physical Medicine & Rehabilitation Physician | $114.2K | $18.1K |
| Allan Marinas | IL | Occupational Therapist | $116.5K | $0 |
| Margaret Hilton | IL | Physical Therapist | $98.4K | $0 |
| Frank Liao | IL | Surgery Physician | $76.6K | $2.5K |
| Paul Guske | IL | Specialist | $65.8K | $0 |
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