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NPI 1306599451 · Warrenville, IL · Clinical Medical Laboratory
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Cipher Global LLC is a clinical medical laboratory provider located in Warrenville, Illinois. This profile covers 5 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 | Cipher Global LLC |
| Address | 3s517 Winfield Rd Ste D |
| City | Warrenville |
| State | IL |
| ZIP | 60555 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 29, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $45.1M |
| Medicaid | $95.2K |
CIPHER GLOBAL LLC’s Medicare business is overwhelmingly driven by a single code: K1034 (Provision of covid-19 test, nonprescription self-administered and self-collected use), which is recorded at 3.8M claims, $12 avg paid/claim and $46M revenue and is labeled an extreme outlier nationally; the platform’s precomputed metric shows the provider’s top 3 Medicare codes account for 99.9% of its total Medicare revenue, indicating an exceptionally concentrated Medicare revenue stream.
The provider’s Medicaid footprint is tiny compared with Medicare — total Medicaid revenue is $95.2K versus $45.1M in Medicare — effectively making Medicare the dominant payer for this entity. Despite the small Medicaid total, the top 3 Medicaid codes account for 90.8% of Medicaid revenue, showing concentration across both payers but at very different scales.
The code mix and descriptions indicate a specialized COVID-19 testing operation: heavy volumes of K1034 (retail/nonprescription self-tests) combined with claims for U0004 and U0005 (high-throughput nucleic acid testing) and 87426 (antigen immunoassay) suggest this entity operates both distribution of self-collection tests and laboratory testing capacity rather than a broad clinical laboratory service line. This pattern is consistent with a business model centered on pandemic-era testing products and specimen processing.
K1034 is a defining competitive advantage for this provider: it ranks #2 of 30143 providers nationally (100th percentile) for that code, marking the provider as a dominant national supplier for nonprescription self-administered COVID-19 tests. By contrast, other Medicare codes on file (U0004, U0005, 87426, G2023) are described as typical or unremarkable in volume, so the provider’s leadership is highly code-specific rather than broad-based across lab services.
Medicaid-specific volumes show a different mix and reimbursement pattern: U0004 is the largest Medicaid code by revenue ($55.6K, 842 claims, $66 avg paid/claim and 57.7% of Medicaid revenue) and 87426 contributes $25.1K (783 claims, $32 avg paid/claim). K1034 also appears in Medicaid but at far lower revenue and much lower avg payment ($6.8K from 6.8K claims, $1 avg paid/claim) while still ranking #2 of 59 in-state (98th percentile) — signaling a strong in-state presence for self-test distribution but with very different reimbursement terms on Medicaid.
The provider’s payer mix and per-claim payments highlight cross-payer differences: K1034 yields $12 avg paid/claim on Medicare but only $1 avg paid/claim on Medicaid, and the bulk of aggregated revenue is concentrated on Medicare reimbursements. Analysts should view the organization as effectively single-payer-dependent at scale, with substantial exposure to Medicare policy and reimbursement shifts for the K1034 service line.
Tenure is short relative to large incumbents: the NPI was enumerated 2022-01-29 (~4 years ago), so this concentrated, high-volume pattern—particularly the national outlier status on K1034—was established within a relatively recent operational window. That short timeframe paired with very concentrated revenue suggests rapid scale-up in a narrow service niche.
The firm’s concentration in one dominant revenue driver introduces strategic and operational risk: with the top 3 Medicare codes accounting for 99.9% of Medicare revenue and the top 3 Medicaid codes accounting for 90.8% of Medicaid revenue, a change in coverage, coding, or reimbursement for K1034 or related COVID testing codes would materially alter the provider’s revenue profile. Competitive standing is therefore asymmetric — nationally dominant for one code but otherwise participating at typical volumes across other common COVID-19 testing codes.
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 |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 3,829,500 | $10 | $46M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 530 | $70 | $39.5K |
| 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,… | 530 | $30 | $13.1K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 350 | $40 | $12.3K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 530 | $20 | $12.2K |
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 840 | $70 | $55.6K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 780 | $30 | $25.1K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 6,800 | $1 | $6.8K |
| 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,… | 370 | $20 | $5.5K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 210 | $20 | $3.4K |
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
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 23 | 50 | 710 | $70 | $1.2M |
| 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,… | 124 | 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 | 253 | 400 | 550 | $20 | $90.8K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 124 | 910 | 110 | $30 | $14.4K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 2 | 60 | 660 | $1 | $3.2K |
Other providers in the same ZIP code as Cipher Global LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Phonak, LLC | IL | Durable Medical Equipment & Medical Supplies | $0 | $5.1M |
| Illinois Proton Center LLC | IL | Radiation Oncology Clinic/Center | $4.3M | $11.1K |
| Cadence Ambulatory Surgery Center, LLC | IL | Ambulatory Surgical Clinic/Center | $705.8K | $0 |
| William Sterba | IL | Orthopaedic Surgery Physician | $413.4K | $1000 |
| Aaron Bare | IL | Orthopaedic Surgery Physician | $277.5K | $78.4K |
| Nasiruddin Mohammed | IL | Radiation Oncology Physician | $260.5K | $380 |
| Debdut Biswas | IL | Orthopaedic Hand Surgery Physician | $104.4K | $152.9K |
| Tiffany Kadow | IL | Surgery of the Hand (Surgery) Physician | $99.6K | $101K |
| Kristine Torio | IL | Physician Assistant | $170.7K | $0 |
| Vinai Gondi | IL | Radiation Oncology Physician | $163.4K | $820 |
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