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NPI 1457003329 · Mt Pleasant, WI · Clinical Medical Laboratory
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Beta Diagnostic Labs LLC is a clinical medical laboratory provider located in Mt Pleasant, Wisconsin. This profile covers 26 Medicare and 27 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 | Beta Diagnostic Labs LLC |
| Address | 7200 Washington Ave Ste 104 |
| City | Mt Pleasant |
| State | WI |
| ZIP | 53406 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 21, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $8.4M |
| Medicare | $1.7M |
BETA DIAGNOSTIC LABS LLC operates as a high-throughput clinical medical laboratory with a clear focus on molecular respiratory and infectious-agent testing; its Medicare top codes include 87798 ($337.4K, 20.2%), 87502 ($273.9K, 16.4%), and 87634 ($201K, 12.0%), and the Medicaid top codes are dominated by 87637 ($4.8M, 56.7%), 87798 ($708K, 8.4%), and 87502 ($612.8K, 7.3%). Multiple listed codes (87502, 87634, 87637, U0003/U0005) refer to amplified nucleic acid or multiplex respiratory panels for SARS‑CoV‑2, influenza, and RSV, indicating the lab’s primary service line is molecular infectious-disease diagnostics and large-scale respiratory surveillance. The presence of high-volume specimen-collection billing via G2023 on both payers supports an end-to-end testing workflow that includes sample intake at scale.
Revenue concentration is high in both payers but especially in Medicaid: the precomputed top-3 Medicare codes account for 48.5% of the provider’s Medicare revenue, while the top-3 Medicaid codes account for 72.3% of the provider’s Medicaid revenue. This indicates Medicare revenue is somewhat concentrated among a few molecular test codes, but Medicaid revenue is heavily concentrated in a single dominant service line (multiplex respiratory testing). High single-service concentration on Medicaid implies business sensitivity to volume or reimbursement changes for those specific codes.
The payer mix is heavily skewed toward Medicaid in aggregate: the provider reports $1.7M in total Medicare revenue versus $8.4M in total Medicaid revenue, making Medicaid the substantially larger source of lifetime revenue. Practically, this means the lab’s financial exposure and growth prospects are more tied to Medicaid contracting, reimbursement policy, and state-level test volumes than to Medicare.
BETA DIAGNOSTIC LABS shows strong competitive dominance in Wisconsin for core respiratory assays: 87637 ranks #1 of 77 in-state providers (100th percentile; extreme outlier) on Medicaid and 87637 also appears in the provider’s Medicare top list (1.4K claims, $192.4K, 11.5% Medicare). Similarly, 87798 and 87502 each rank #1 in-state for Medicaid (100th percentile; extreme outlier), demonstrating the lab is a major—often market-leading—supplier of these tests within the state.
At the national level for Medicare, the provider is an outlier on certain high-volume COVID/respiratory codes: 87502 ranks #13 of 3547 providers nationally (100th percentile; extreme outlier) and 87634 ranks #11 of 411 providers nationally (98th percentile; notably above typical national volume). Other Medicare codes such as 87798 rank in the 90th percentile nationally (typical, unremarkable volume), which suggests the lab combines a few exceptionally high-volume molecular services with a broader set of routine lab offerings.
Several individual codes are explicitly labelled as statistical outliers in the supplied comparisons and reinforce the lab’s specialization: on Medicaid 87637, 87798, 87502, 87634, 87581 and 87486 are each indicated as “extreme outlier, far above typical state volume,” and on Medicare 87502 is an “extreme outlier” nationally while 87634 is “notably above typical national volume.” These characterizations point to unusually large testing volumes for multiplex respiratory and other nucleic-acid assays relative to peers, not to any operational detail beyond scale.
Operational capacity signals appear in throughput-related codes: the use of U0003 and U0005 (Medicare U0003 $160.3K, 9.6% and Medicare U0005 $54.1K, 3.2%; Medicaid U0003 $571.1K, 6.8% and Medicaid U0005 $188.6K, 2.2%) and very large G2023 Medicaid claim volume (50.8K claims, $355.9K, 4.2% Medicaid) are consistent with deployment of high-throughput testing platforms and centralized specimen processing. Payers and network managers should interpret these lines as indicative of a lab set up for high-volume, rapid-turnaround molecular testing rather than low-volume specialty pathology.
The provider’s NPI was enumerated on 2022-01-21 (~4 years ago), indicating relatively recent entry into national billing rosters. Given the short tenure combined with outsized Medicaid and targeted Medicare volumes on a narrow set of molecular codes, the lab appears to have rapidly scaled a specific respiratory/infectious testing business line in a short time frame.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 9,920 | $30 | $337.4K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 2,910 | $90 | $273.9K |
| 87634 | The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique. | 2,910 | $70 | $201K |
| 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)… | 1,370 | $140 | $192.4K |
| 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… | 2,170 | $70 | $160.3K |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 2,920 | $30 | $99.2K |
| 87541 | The lab analyst performs a test for the bacteria Legionella pneumophila using amplified nucleic acid probe technique. L. pneumophila can inhabit facility water and air conditioning systems and may… | 2,920 | $30 | $99.2K |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 2,920 | $30 | $99.2K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 3,230 | $20 | $74.2K |
| 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,… | 2,160 | $30 | $54.1K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87634 | 1 | 10 | 1,470 | $70 | $100.9K |
| 87541 | 1 | 10 | 2,920 | $30 | $100.3K |
| U0003 | 2 | 10 | 430 | $70 | $61.9K |
| 87502 | 1 | 10 | 10 | $90 | $55.8K |
| 87486 | 1 | 10 | 1,470 | $30 | $50.6K |
| 87581 | 1 | 10 | 1,470 | $30 | $50.6K |
| 87798 | 1 | 10 | 350 | $30 | $41.1K |
| G2023 | 1 | 10 | 1,820 | $20 | $39.6K |
| U0005 | 2 | 10 | 420 | $20 | $20.8K |
| 87637 | 1 | 20 | 20 | $140 | $12.6K |
Showing 1–10 of 26
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
27 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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)… | 51,500 | $90 | $4.8M |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 22,840 | $30 | $708K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 18,020 | $30 | $612.8K |
| 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… | 16,800 | $30 | $571.1K |
| 87634 | The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique. | 18,040 | $20 | $433K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 50,840 | $10 | $355.9K |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 18,280 | $10 | $237.7K |
| 87541 | The lab analyst performs a test for the bacteria Legionella pneumophila using amplified nucleic acid probe technique. L. pneumophila can inhabit facility water and air conditioning systems and may… | 17,960 | $10 | $233.4K |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 17,910 | $10 | $232.8K |
| 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,… | 17,140 | $10 | $188.6K |
Showing 1–10 of 27
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
27 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… | 10 | 20 | 320 | $60 | $483K |
| 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… | 12 | 170 | 720 | $70 | $272.7K |
| 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)… | 1 | 80 | 650 | $110 | $244.4K |
| 87541 | The lab analyst performs a test for the bacteria Legionella pneumophila using amplified nucleic acid probe technique. L. pneumophila can inhabit facility water and air conditioning systems and may… | 1 | 10 | 17,960 | $10 | $227.6K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 110 | 160 | 990 | $30 | $191.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 109 | 160 | 970 | $30 | $174.2K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 5 | 10 | 130 | $70 | $100.1K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 167 | 260 | 750 | $40 | $99K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 1 | 170 | 330 | $80 | $90.9K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2 | 20 | 70 | $10 | $76.1K |
Showing 1–10 of 27
Other providers in the same ZIP code as Beta Diagnostic Labs LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Familia Dental Racine LLC | WI | Dental Clinic/Center | $0 | $17.9M |
| Idental LLC | WI | Dentist | $0 | $11.7M |
| Developmental Disabilities Information Service, Inc. | WI | Case Management Agency | $0 | $10.9M |
| Mynt Dental Racine LLC | WI | General Practice Dentistry | $0 | $4.2M |
| Covid Care Zone Inc | WI | Clinical Medical Laboratory | $71.4K | $3.6M |
| Sweet Smiles Mt. Pleasant LLC | WI | General Practice Dentistry | $0 | $3.6M |
| Chad Novasic Pt Ltd | WI | Physical Therapist | $0 | $2.6M |
| Paramount Pediatric Dentistry Of Racine | WI | Pediatric Dentistry | $0 | $2.3M |
| Sasan Molavi | WI | Dentist | $0 | $2.1M |
| Wisconsin Smiles | WI | Dental Clinic/Center | $0 | $1.4M |
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