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NPI 1275060931 · Wood Dale, IL · Clinical Medical Laboratory
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Optimalab Inc is a clinical medical laboratory provider located in Wood Dale, Illinois. This profile covers 66 Medicare and 52 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 | Optimalab Inc |
| Address | 210 Mittel Dr Ste 2 |
| City | Wood Dale |
| State | IL |
| ZIP | 60191 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 12, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $20.4M |
| Medicare | $4M |
OPTIMALAB INC is a high-volume clinical testing operation with a dominant focus on SARS-CoV-2 molecular testing and related specimen-collection services across both Medicare and Medicaid. The top Medicare CPT/HCPCS codes are U0003, U0005, and G2024, and the top Medicaid codes are the same three; these codes correspond to high-throughput nucleic acid detection for SARS-CoV-2 and specimen collection, indicating the business is primarily structured around COVID-19 testing workflow and outreach.
Revenue concentration is extreme for both payers. Precomputed totals show the top 3 Medicare codes account for 85.9% of this provider's total Medicare revenue, and the top 3 Medicaid codes account for 99.1% of its total Medicaid revenue, signaling very high dependency on a narrow set of test and collection codes for overall billing.
Payer mix is heavily weighted toward Medicaid by dollars: total Medicaid revenue is $20.4M versus total Medicare revenue of $4M, making Medicaid the materially larger source of billed revenue for this provider. This profile suggests OPTIMALAB operates at scale in the Medicaid population or through state contracts/arrangements that produced far greater Medicaid testing volume than Medicare.
OPTIMALAB is a major state-level player for Medicaid SARS-CoV-2 testing: U0003 ranks #3 of 350 in-state and is described as an extreme outlier, and U0005 ranks #3 of 210 in-state (99th percentile). G2024 ranks #1 of 20 in-state and is noted as notably above typical state volume. Collectively these ranks indicate the provider is among the largest Medicaid COVID-19 testing suppliers in Illinois.
On Medicare, the provider is also an outlier for COVID testing volume. U0003 and U0005 each rank #8 nationally (99th percentile; extreme outlier) and G2024 ranks #1 of 79 providers nationally (100th percentile), indicating OPTIMALAB is a major national outlier in claims volume for these COVID-19 related codes relative to its Medicare peers.
Operational footprint implied by ancillary codes: high counts for travel allowances (P9603 and P9604) and specimen collection codes (G2024, G2023) show substantial field or mobile specimen-collection activity, including visits to SNFs or homebound patients. This supports an operational model that combines high-throughput laboratory processing with decentralized collection services.
Although COVID-19 testing codes dominate revenue, the lab also bills a broad set of routine clinical chemistry and hematology tests (e.g., 84443, 82306, 83036, 82607) at modest volumes relative to its COVID work. These codes appear across both payers but contribute only small shares of revenue, suggesting COVID testing is the core commercial driver while routine panels are secondary.
Tenure: the NPI was enumerated on 2017-05-12 (~9 years ago), indicating the provider has been registered long enough to scale testing operations and secure meaningful Medicare and Medicaid billing relationships since initial enumeration.
Given the extremely concentrated revenue mix and the outlier ranking on a small set of COVID-related codes, payers and competitive analysts should treat OPTIMALAB as a specialized, high-capacity COVID testing vendor with significant Medicaid exposure; contract or utilization reviews should prioritize the U0003/U0005/G2024 code group where nearly all revenue is generated.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
66 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 28,100 | $70 | $2.1M |
| 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,… | 28,070 | $30 | $701.9K |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 24,490 | $30 | $612.4K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 94,320 | $1 | $94.3K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 2,460 | $30 | $71.3K |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 4,430 | $10 | $48.8K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 2,760 | $20 | $44.2K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 2,210 | $20 | $33.2K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 2,580 | $10 | $25.8K |
| 84481 | The lab analyst performs a test to measure free T3 in patient blood. | 1,490 | $20 | $25.3K |
Showing 1–10 of 66
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 66 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
66 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| U0003 | 4 | 100 | 230 | $70 | $249.1K |
| P9603 | 14 | 40 | 35,960 | $1 | $232.2K |
| G2024 | 1 | 10 | 2,550 | $20 | $195.3K |
| G2023 | 72 | 90 | 400 | $20 | $96.5K |
| G0480 | 16 | 20 | 50 | $110 | $89.9K |
| U0005 | 4 | 100 | 270 | $20 | $86.3K |
| 87634 | 11 | 30 | 20 | $70 | $29.9K |
| 80307 | 34 | 70 | 120 | $60 | $27.2K |
| G0481 | 7 | 20 | 50 | $150 | $26.5K |
| 82172 | 2 | 10 | 110 | $20 | $19.9K |
Showing 1–10 of 66
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.
52 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 235,040 | $60 | $14.8M |
| 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,… | 185,460 | $20 | $3.5M |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 98,140 | $20 | $2M |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,660 | $20 | $47.8K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 2,220 | $10 | $26.7K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 2,190 | $10 | $19.7K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 420 | $40 | $16.9K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 1,270 | $10 | $12.7K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 1,930 | $10 | $9.7K |
| 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… | 150 | $60 | $8.8K |
Showing 1–10 of 52
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
52 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 68 | 70 | 570 | $50 | $565.6K |
| 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… | 3 | 350 | 400 | $70 | $514.7K |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 1 | 20 | 470 | $20 | $351.2K |
| 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… | 19 | 30 | 420 | $70 | $308.4K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 182 | 280 | 1,120 | $30 | $218.9K |
| 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,… | 3 | 210 | 680 | $20 | $206.4K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 77 | 400 | 550 | $20 | $90.8K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 356 | 740 | 960 | $10 | $75.9K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 172 | 530 | 840 | $10 | $73.9K |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 13 | 20 | 1,750 | $10 | $66.6K |
Showing 1–10 of 52
Other providers in the same ZIP code as Optimalab Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Quest Diagnostics LLC Il | IL | Clinical Medical Laboratory | $40.3M | $429.8M |
| Kci Usa, Inc. | IL | Durable Medical Equipment & Medical Supplies | $0 | $20.8M |
| Dominic Tolitano | IL | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | $1.1M | $0 |
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