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NPI 1407424328 · Elizabeth, NJ · Clinical Medical Laboratory
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Covigen Medtox Lab Inc. is a clinical medical laboratory provider located in Elizabeth, New Jersey. 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 | Covigen Medtox Lab Inc. |
| Address | 700 N Broad St Ste 103 |
| City | Elizabeth |
| State | NJ |
| ZIP | 07208 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 16, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $10.4M |
| Medicaid | $287.2K |
This provider’s payer mix is heavily skewed toward Medicare: lifetime Medicare revenue is $10.4M compared with $287.2K in lifetime Medicaid revenue, indicating Medicare accounts for the vast majority of reported billing and cash flow. The Medicaid program appears to be a much smaller part of overall activity rather than a co-equal payer.
Medicare revenue is extremely concentrated in a single code: K1034 generated $10.6M in revenue and, per precomputation, the top 3 Medicare codes account for 100.0% of this provider’s total Medicare revenue. K1034 therefore represents the provider’s primary Medicare business line rather than one of many comparable products.
The substance of the top Medicare code suggests a business model focused on nonprescription, self-administered COVID testing: K1034 is the provision of covid-19 test, nonprescription self-administered and self-collected use, and it drives the provider’s entire Medicare book of business. That code mix implies operations oriented toward large-scale distribution or processing of at-home/self-collected COVID tests rather than diversified clinical laboratory panels.
Medicaid billing is also highly concentrated: the top 3 Medicaid codes (U0003, U0005, and G2023) together account for 98.0% of Medicaid revenue, with U0003 at $200.5K (69.5% of Medicaid revenue), U0005 at $59.9K (20.8%), and G2023 at $22.5K (7.8%). These codes point to high-throughput nucleic acid SARS-CoV-2 testing and associated specimen collection as the primary Medicaid services, while smaller Medicaid items such as P9604 and K1034 contribute only marginally.
Competitive standing differs sharply between payers and codes. For Medicare, K1034 places the provider at #50 of 30143 providers nationally (100th percentile; extreme outlier), signaling national-scale volume that far exceeds typical providers for that code. In Medicaid, the provider’s U0003 rank (#64 of 127, 50th percentile) and U0005 rank (#87 of 142, 39th percentile) are in the middle or lower-middle of state peers, while G2023 at #47 of 179 (74th percentile) shows a modestly stronger position for specimen collection relative to other Medicaid billers in-state.
There are notable statistical outlier signals to reconcile: K1034 is labeled an “extreme outlier” nationally for Medicare and the same code is a #1 in-state outlier for Medicaid (rank #1 of 53, 100th percentile) despite only $1.1K in Medicaid revenue for that code. This means the provider is an outlier on K1034 billing patterns relative to peers at both levels, but the practical financial impact of that Medicaid K1034 outlier is small in absolute dollars.
The provider’s NPI was enumerated on 2021-06-16 (~5 years ago), indicating a relatively recent enrollment. Coupled with $10.4M in Medicare revenue dominated by pandemic-era testing codes, the data are consistent with a business that scaled quickly around COVID-19 testing services after its 2021 enumeration rather than a long-established, diversified clinical laboratory footprint.
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 | 881,100 | $10 | $10.6M |
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 | 1 | 1,010 | 760 | $10 | $33.9K |
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 |
|---|---|---|---|---|
| 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… | 3,180 | $60 | $200.5K |
| 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,… | 2,720 | $20 | $59.9K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,820 | $10 | $22.5K |
| 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 | 1,150 | $1 | $4.6K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,050 | $1 | $1.1K |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey 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… | 64 | 130 | 3,180 | $60 | $4.2M |
| 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,… | 87 | 140 | 5,590 | $20 | $823.1K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 47 | 180 | 320 | $10 | $116.9K |
| 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 | 11 | 30 | 750 | $1 | $39.9K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1 | 50 | 50 | $1 | $360 |
Other providers in the same ZIP code as Covigen Medtox Lab Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bridgeway Behavioral Health Services | NJ | Case Management Agency | $0 | $62.4M |
| Elizabeth Public Schools | NJ | Local Education Agency (LEA) | $0 | $47.4M |
| Home Sweet Home Operations LLC | NJ | Adult Day Care Clinic/Center | $0 | $30.8M |
| Frank Aguirre | NJ | Specialist | $55.9K | $0 |
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