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NPI 1285302273 · Chicago, IL · Clinical Medical Laboratory
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Western Labs Company is a clinical medical laboratory provider located in Chicago, Illinois. This profile covers 1 Medicare and 5 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 | Western Labs Company |
| Address | 225 N Western Ave Ste B |
| City | Chicago |
| State | IL |
| ZIP | 60612 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 2, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $18.4M |
| Medicaid | $8.4K |
Operational profile: Billing is overwhelmingly concentrated in SARS‑CoV‑2 testing and associated specimen services, with the Medicare top code K1034 (provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared) driving the activity. Medicaid claims also show a COVID testing mix (K1034, U0003, G2023, 87811), indicating the lab’s service line is focused on COVID test provision and high-throughput molecular testing rather than a broad panel of clinical lab services.
Medicare revenue concentration: The provider’s Medicare activity is highly concentrated — precomputed data show the top 3 Medicare codes account for 100.0% of Medicare revenue, and K1034 alone is reported at 1.6M claims, $12 avg paid/claim, $18.8M revenue and listed as 100.0% of this provider’s total Medicare revenue. This indicates a single-code revenue dependency on Medicare-covered COVID test provision.
Medicaid revenue concentration: On Medicaid the top 3 codes account for 93.2% of the provider’s Medicaid revenue, with K1034 reported at 2.9K claims, $2 avg paid/claim, $5.7K revenue (74.1% of Medicaid revenue), followed by U0003 ($910, 11.8%) and G2023 ($572, 7.4%). Medicaid receipts are therefore also concentrated in COVID-related codes, though spread across a small set rather than a single dominant code.
Payer mix and scale: This entity is effectively single‑payer at scale — total Medicare revenue is $18.4M versus total Medicaid revenue of $8.4K, showing Medicare is overwhelmingly the revenue source. Medicaid activity exists but is economically immaterial compared with Medicare, so any commercial or state-level strategy would be secondary to the Medicare COVID testing channel.
Medicare competitive standing: For the Medicare-dominant code K1034 the provider ranks #19 of 30143 providers nationally (100th percentile; extreme outlier), signaling national-scale volume for that specific CPT/HCPCS code far above typical peers. That national ranking identifies the provider as an outlier/dominant volume participant for Medicare‑billed K1034 activity.
Medicaid competitive standing: The same K1034 code on Medicaid ranks #11 of 59 in-state (83th percentile; typical, unremarkable volume), while other Medicaid codes show low state percentiles (U0003 ranks #300 of 350, 13th percentile; G2023 ranks #335 of 396, 15th percentile; 87811 ranks #487 of 548, 10th percentile). Those ranks indicate the provider is not a statewide leader in laboratory analytic or PCR testing codes despite a notable presence in Medicaid K1034 claims.
Statistical contrast across payers: There is a striking dichotomy between payers — K1034 is an "extreme outlier" on Medicare but only "typical, unremarkable" on Medicaid in-state rankings. This suggests the provider’s large Medicare volumes for K1034 may reflect a billing footprint or contract structure that does not translate into comparable Medicaid market dominance.
Tenure and likely timing of growth: The provider’s NPI was enumerated on 2021-09-02 (~5 years ago), which aligns with pandemic-era enrollment and suggests the organization’s rapid growth and revenue profile are likely tied to COVID testing demand established during that period. Tenure information supports an interpretation that the business was established or scaled up to supply pandemic-related testing services.
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 | 1,565,670 | $10 | $18.8M |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 7 | 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.
5 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 | 2,860 | $1 | $5.7K |
| 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… | 30 | $40 | $910 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 50 | $10 | $570 |
| 87811 | The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by… | 30 | $20 | $490 |
| 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,… | 10 | $1 | $30 |
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
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 300 | 350 | 400 | $70 | $514.7K |
| 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,… | 202 | 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 | 335 | 400 | 550 | $20 | $90.8K |
| 87811 | The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by… | 487 | 550 | 240 | $40 | $42.4K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 11 | 60 | 660 | $1 | $3.2K |
Other providers in the same ZIP code as Western Labs Company, ranked by combined Medicare and Medicaid revenue.
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