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NPI 1346389764 · Schaumburg, IL · Clinical Medical Laboratory
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Quest Diagnostics LLC Il is a clinical medical laboratory provider located in Schaumburg, Illinois. This profile covers 43 Medicare and 78 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 | Quest Diagnostics LLC Il |
| Address | 506 E State Pkwy |
| City | Schaumburg |
| State | IL |
| ZIP | 60173 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 5, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $50.7M |
| Medicare | $3.5M |
This entity is effectively Medicaid‑centric by revenue: reported Medicare revenue is $3.5M versus Medicaid revenue of $50.7M, indicating Medicaid accounts for the large majority of billed volume and payments. The NPI was enumerated on 2007-02-05 (~19 years ago), so this is an established operator with a long active presence in claims data.
The provider’s top Medicare codes (88305, 81513, U0003) point to a hybrid clinical laboratory offering both surgical pathology/cytology and high‑volume molecular infectious disease testing. 88305 ($681.9K) reflects substantial surgical pathology activity, while 81513 ($448.3K) and U0003 ($370.4K) indicate algorithmic molecular assays and high‑throughput SARS‑CoV‑2 PCR capacity respectively, consistent with a centralized lab processing large numbers of specimens.
Medicare revenue is concentrated: the top three Medicare codes account for 44.7% of the provider’s Medicare revenue. Those top Medicare drivers are 88305 ($681.9K, 20.3%), 81513 ($448.3K, 13.4%), and U0003 ($370.4K, 11.0%), which suggests a material dependence on a small set of pathology and molecular diagnostic services for Medicare income.
Medicaid revenue is even more concentrated: the top three Medicaid codes account for 60.9% of the provider’s Medicaid revenue. The leading Medicaid codes are U0003 ($12.4M, 24.7%), 87591 ($9.1M, 18.2%), and 87491 ($9M, 18.0%), showing heavy reliance on SARS‑CoV‑2 testing and high‑volume sexually transmitted infection (GC/CT) molecular testing for Medicaid payor dollars.
On national Medicare measures the provider is a major outlier for several services: 88305 ranks #50 of 14580 (100th percentile; extreme outlier) and 81513 ranks #2 of 105 (99th percentile; extreme outlier), indicating volumes far above typical national peers for those codes. Some other Medicare molecular and cytology codes are also at or near top percentiles (for example, 87624 ranks #7 of 475 at the 99th percentile), reinforcing that the provider operates at unusually high scale for these tests.
Within Illinois Medicaid the provider is consistently a statewide leader for high‑volume diagnostics: U0003 ranks #4 of 350 (99th percentile; extreme outlier), 87591 ranks #2 of 363 (100th percentile; extreme outlier), and 87491 ranks #2 of 362 (100th percentile; extreme outlier). Multiple cytology and related codes also rank at or near the top in‑state (for example, G0145 ranks #1 of 18, 100th percentile), which signals dominant market share in several test lines for Medicaid.
Claim volumes in Medicaid demonstrate very high operational throughput: examples include 87591 at 260.5K claims, 87491 at 258.4K claims, and U0003 at 165.4K claims, each generating multimillion‑dollar revenues. These counts are consistent with a centralized reference lab model that processes mass testing for infectious disease and STI screening in the Medicaid population.
The provider’s mix shows both technical and professional service breadth: substantial paid claims and revenue for cytopathology and surgical pathology (e.g., Medicare 88305 $681.9K and Medicaid 88305 $1000K) alongside algorithmic and molecular assays (81513, U0003, 87591, 87491). This pattern suggests an operational footprint that combines specimen processing and diagnostic interpretation across women’s health screening, STI panels, and high‑throughput infectious disease testing rather than a narrow single‑test focus.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
43 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 25,250 | $30 | $681.9K |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 3,200 | $140 | $448.3K |
| 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… | 5,010 | $70 | $370.4K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 3,270 | $70 | $225.6K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 4,950 | $30 | $168.1K |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under… | 5,740 | $30 | $149.2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 4,350 | $30 | $147.9K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 4,320 | $30 | $147K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 4,010 | $30 | $136.3K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 1,590 | $80 | $131.6K |
Showing 1–10 of 43
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
43 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| U0003 | 10 | 100 | 230 | $70 | $249.1K |
| 81513 | 1 | 10 | 80 | $140 | $118.9K |
| U0005 | 14 | 100 | 270 | $20 | $86.3K |
| 87536 | 1 | 10 | 850 | $80 | $70.4K |
| G0145 | 1 | 10 | 410 | $30 | $55.5K |
| 87801 | 3 | 30 | 120 | $70 | $52.2K |
| 87636 | 9 | 120 | 30 | $140 | $50K |
| 88305 | 2 | 580 | 610 | $30 | $38.2K |
| 87506 | 3 | 10 | 110 | $260 | $27.6K |
| 87631 | 4 | 30 | 40 | $140 | $23.9K |
Showing 1–10 of 43
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.
78 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… | 165,440 | $80 | $12.4M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 260,520 | $40 | $9.1M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 258,430 | $40 | $9M |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 47,300 | $90 | $4M |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 113,090 | $30 | $2.8M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 64,550 | $40 | $2.6M |
| 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,… | 88,420 | $20 | $2M |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 63,190 | $30 | $1.6M |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 71,590 | $20 | $1.3M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 30,300 | $30 | $1000K |
Showing 1–10 of 78
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
78 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 2 | 10 | 210 | $70 | $1.4M |
| 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… | 4 | 350 | 400 | $70 | $514.7K |
| 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)… | 59 | 80 | 530 | $130 | $505.1K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 8 | 130 | 70 | $120 | $240.2K |
| 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,… | 5 | 210 | 680 | $20 | $206.4K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 33 | 170 | 150 | $200 | $190.9K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 155 | 250 | 450 | $40 | $185.7K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 2 | 110 | 150 | $40 | $184.1K |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 26 | 30 | 170 | $50 | $169.7K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 2 | 360 | 600 | $30 | $165.1K |
Showing 1–10 of 78
Other providers in the same ZIP code as Quest Diagnostics LLC Il, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Alpha Lab Services Inc | IL | Clinical Medical Laboratory | $15.4M | $2.4K |
| Prism Health Care Services, Inc. | IL | Durable Medical Equipment & Medical Supplies | $0 | $4.9M |
| Trinity Care Providers Inc | IL | In Home Supportive Care Agency | $0 | $3.7M |
| Laxmi Deshabathini | IL | Family Nurse Practitioner | $3.3M | $13.7K |
| Ritesh Patel | IL | Internal Medicine Physician | $255.6K | $2.2M |
| Solomon Sager | IL | Clinical Cardiac Electrophysiology Physician | $1M | $236.9K |
| Mednow Laboratory LLC | IL | Clinical Medical Laboratory | $1.1M | $0 |
| Parag Doshi | IL | Interventional Cardiology Physician | $885K | $122.5K |
| Aasita Patel | IL | Cardiovascular Disease Physician | $843.1K | $72.5K |
| Elsayed Mohamed | IL | Interventional Cardiology Physician | $790K | $38.8K |
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