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NPI 1457354656 · Chicago, IL · Anatomic Pathology & Clinical Pathology Physician
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Frederick Behm is a anatomic pathology & clinical pathology physician provider located in Chicago, Illinois. This profile covers 1 Medicare and 336 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 | Individual |
| Organization | Frederick Behm |
| Address | 840 S Wood St |
| City | Chicago |
| State | IL |
| ZIP | 60612 |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| NPI Enumerated | May 23, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $32.3M |
| Medicare | $440 |
This provider’s payer mix is heavily weighted toward Medicaid: reported Medicaid revenue is $32.3M versus just $437 in Medicare, making the practice effectively Medicaid-dominant in scale. The tiny Medicare take relative to Medicaid indicates the provider’s billing and service footprint is concentrated in state programs rather than in the Medicare market.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 100.0% of Medicare revenue, and the single listed Medicare code 85060 accounts for the entire $437. For 85060 the provider ranks #1732 of 2638 nationally (32th percentile; typical, unremarkable volume for this code), which characterizes its Medicare participation as modest and not a primary revenue source.
On the Medicaid side the top three codes 87389, 87633, and 87491 drive a combined 33.0% of Medicaid revenue, specifically $2.9M (13.0%), $2.9M (12.8%), and $1.6M (7.2%) respectively. Those three codes are high-volume infectious-disease/molecular tests and together form a substantial share of the provider’s Medicaid revenue base, highlighting dependence on diagnostic testing lines.
The code mix and volumes indicate a high-throughput clinical laboratory operation focused on infectious disease and molecular diagnostics: examples include 87389 (63.4K claims, $2.9M), 87633 (15.9K claims, $2.9M), U0003 (26.1K claims, $1.6M), 87635 (34.6K claims, $1.2M), and large screening panels such as 80048 (218.4K claims, $1.1M) and 85025 (272.4K claims, $1.1M). The combination of multiplex respiratory panels, SARS‑CoV‑2 NAATs, HIV screening, STD NAATs, and massive routine chemistry/CBC volumes points to automated, centralized specimen processing rather than low-volume consult pathology work.
The provider is a competitive outlier in many Medicaid codes statewide: 87633 ranks #1 of 167 (100th percentile; extreme outlier), 87389 ranks #2 of 249 (100th percentile; notably above typical state volume), and multiple other tests (e.g., 80048, 83735, 84100, 80076) are ranked #1 or #2 and labeled extreme outliers or 100th percentile. These rank/percentile signals position the provider as a dominant in‑state performer for a broad set of lab assays.
Despite that in-state dominance for Medicaid, the provider’s national standing for Medicare is limited; the Medicare code 85060 is characterized as typical and unremarkable nationally, indicating little Medicare market footprint. Analysts should treat the practice as a state-focused high-volume lab rather than a nationally prominent Medicare pathology biller.
Revenue profile shows a reliance on large-count, low-dollar tests as a material part of Medicaid revenue: for example 85025 (272.4K claims, $1.1M), 80048 (218.4K claims, $1.1M), and 80053 (164.4K claims, $986.3K) together illustrate a business model optimized for volume and automation with low average paid/claim amounts. This mix implies operational emphasis on throughput efficiency and specimen processing scale.
Provider tenure is long-established: NPI enumerated 2005-05-23 (~21 years ago). Combined with the current Medicaid volumes and multiple 100th-percentile rankings, the data suggest sustained, long-term lab operations and a steady institutional role in state Medicaid diagnostic testing rather than a recent entrant or small solo pathology practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 85060 | The physician, typically a clinical pathologist, performs a peripheral blood smear review and provides an interpretation and written report of the examination. | 20 | $20 | $440 |
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 |
|---|---|---|---|---|---|
| 85060 | 115 | 150 | 30 | $20 | $1.7K |
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.
336 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 63,430 | $50 | $2.9M |
| 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… | 15,850 | $180 | $2.9M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 67,090 | $20 | $1.6M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 66,850 | $20 | $1.6M |
| 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… | 26,090 | $60 | $1.6M |
| 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… | 34,560 | $30 | $1.2M |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 218,440 | $10 | $1.1M |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 272,440 | $1 | $1.1M |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 164,390 | $10 | $986.3K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 49,710 | $20 | $795.3K |
Showing 1–10 of 336
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
336 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 9 | 70 | 570 | $50 | $565.6K |
| 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… | 24 | 350 | 400 | $70 | $514.7K |
| 87799 | The lab analyst performs a test to quantify infection with an infectious agent, not otherwise specified in another code, using a nucleic acid probe technique. Use this code if you know the laboratory… | 4 | 20 | 500 | $30 | $399.9K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 10 | 280 | 1,120 | $30 | $218.9K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 5 | 10 | 80 | $160 | $192K |
| 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… | 1 | 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… | 2 | 250 | 450 | $40 | $185.7K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 20 | 110 | 150 | $40 | $184.1K |
| 80321 | The lab analyst detects and measures the alcohol biomarker in a patient specimen. Alcohol biomarkers are physiological indicators of the alcohol exposure or ingestion. In this test, the analyst tests… | 5 | 10 | 5,190 | $30 | $180.1K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 5 | 360 | 600 | $30 | $165.1K |
Showing 1–10 of 336
Other providers in the same ZIP code as Frederick Behm, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Cook County | IL | Multi-Specialty Clinic/Center | $0 | $85.9M |
| The Thresholds | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $26.1M |
| Sahar Alrayyes | IL | Pediatric Dentistry | $0 | $20.3M |
| Western Labs Company | IL | Clinical Medical Laboratory | $18.4M | $8.4K |
| Susan Rowan | IL | Dentist | $0 | $15.4M |
| Advance Lab Company | IL | Clinical Medical Laboratory | $14.5M | $0 |
| Robert Decresce | IL | Anatomic Pathology & Clinical Pathology Physician | $62K | $12.4M |
| Rush University Medical Center | IL | Early Intervention Provider Agency | $0 | $10.1M |
| Cook County | IL | Multi-Specialty Clinic/Center | $0 | $8.6M |
| Hektoen Institute | IL | Medical Specialty Clinic/Center | $0 | $6.2M |
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