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NPI 1538570528 · Skokie, IL · Clinical Medical Laboratory
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Des Plaines Clinical Lab Inc is a clinical medical laboratory provider located in Skokie, Illinois. This profile covers 129 Medicare and 165 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 | Des Plaines Clinical Lab Inc |
| Address | 8833 Gross Point Rd Ste 308 |
| City | Skokie |
| State | IL |
| ZIP | 60077 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 13, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.5M |
| Medicare | $1.1M |
This provider is heavily Medicaid‑focused: reported Medicaid revenue is $25.5M compared with Medicare revenue of $1.1M, indicating the vast majority of billed revenue comes from Medicaid rather than Medicare. Analysts should treat DES PLAINES CLINICAL LAB INC as a predominantly Medicaid-serving clinical laboratory when evaluating payer negotiations or network capacity.
The code mix indicates a dual operational focus on high-throughput molecular infectious testing and extensive drug-testing services. Medicaid and Medicare top codes include multiple nucleic acid amplification tests (U0003, U0005, 87637, 87635, 87798, 87801) alongside extensive definitive and presumptive drug testing codes (G0483, G0481, G0482, G0480, 80307), and routine chemistry and hematology panels (84443, 80053, 82306, 85025), suggesting the lab operates both large molecular testing workflows and high-volume toxicology/forensic workflows.
Revenue concentration is notable on both payers: the top 3 Medicare codes account for 35.6% of this provider’s Medicare revenue (examples include 87798, G0481, 87150), while the top 3 Medicaid codes account for 46.4% of Medicaid revenue (examples include U0003, G0483, 80307). This means a relatively small set of tests drives a large share of payer revenue and will be the most material services for any utilization or contract review.
At the state level the provider is a major player for several Medicaid codes: 83021 ranks #1 of 60 providers in-state (100th percentile, described as an extreme outlier), G0483 ranks #2 of 22 (95th percentile), and 80307 ranks #3 of 283 (99th percentile, described as notably above typical). These state rankings indicate dominant in‑state capacity for hemoglobin fractionation and multi-class drug testing, which could make the lab an important source of capacity for Medicaid-managed testing needs.
Nationally on Medicare the provider’s standing is more mixed: several common lab tests rank at high percentiles (for example 87635 ranks #139 of 9976 providers, 99th percentile; 82306 ranks #343 of 12453, 97th percentile; 85025 ranks #454 of 32833, 99th percentile), but overall Medicare revenue is limited to $1.1M. In aggregate this positions the lab as a modest national participant for Medicare with select high-volume tests rather than a top national laboratory across the broader Medicare market.
Claim volumes in Medicaid show very high throughput on specific services—U0003 reports 55K claims ($70 avg paid/claim, $3.9M revenue), G0483 reports 38.1K claims ($86 avg paid/claim, $3.3M revenue), and 80307 reports 75.4K claims ($37 avg paid/claim, $2.8M revenue). These raw claim counts and per‑claim payments point to significant specimen logistics and reporting capacity that payers should consider for network utilization planning and turnaround expectations.
DES PLAINES CLINICAL LAB INC has been an enumerated NPI since 2014-05-13 (~12 years ago), indicating an established presence in the market. Combined with the large Medicaid footprint and concentrated high-volume code mix, the provider appears to be a mature lab operation that has scaled specific testing lines over multiple years.
The provider’s revenue profile and state-level outlier status on certain codes create strategic exposure: concentrated revenue (top 3 codes = 46.4% Medicaid) and extreme in‑state positions (e.g., 83021 at 100th percentile) mean changes in Medicaid contracting, fee schedules, or demand for those targeted tests could materially affect the lab’s utilization and revenue. Payers should monitor those high-volume codes and consider capacity and contract implications rather than treating this lab as a generalist low-volume vendor.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
129 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… | 5,160 | $30 | $175.5K |
| G0481 | 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… | 570 | $150 | $87.2K |
| 87150 | The lab analyst performs an analysis using amplified DNA or RNA probe technique on a previously isolated and identified organism to categorize the organism more specifically, such as to the taxonomic… | 2,460 | $30 | $83.6K |
| 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… | 1,110 | $70 | $81.9K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 1,010 | $70 | $69.6K |
| 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… | 610 | $110 | $68.1K |
| 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)… | 440 | $140 | $61.5K |
| 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… | 770 | $50 | $38.6K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,080 | $30 | $36.8K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 1,050 | $30 | $30.5K |
Showing 1–10 of 129
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 129 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
129 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87637 | 9 | 50 | 50 | $140 | $557.3K |
| U0003 | 29 | 100 | 230 | $70 | $249.1K |
| 87150 | 3 | 10 | 1,200 | $30 | $181.3K |
| 87798 | 17 | 70 | 750 | $30 | $172.3K |
| G2023 | 53 | 90 | 400 | $20 | $96.5K |
| G0480 | 4 | 20 | 50 | $110 | $89.9K |
| U0005 | 33 | 100 | 270 | $20 | $86.3K |
| 87801 | 5 | 30 | 120 | $70 | $52.2K |
| 87481 | 16 | 60 | 120 | $30 | $47.3K |
| 87551 | 2 | 10 | 810 | $50 | $38K |
Showing 1–10 of 129
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.
165 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… | 55,000 | $70 | $3.9M |
| G0483 | 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… | 38,140 | $90 | $3.3M |
| 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. | 75,360 | $40 | $2.8M |
| G0481 | 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… | 21,250 | $60 | $1.3M |
| 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,… | 44,500 | $20 | $979.1K |
| G0482 | 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… | 9,870 | $90 | $888.3K |
| 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… | 19,880 | $40 | $855K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 36,120 | $20 | $758.5K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 49,740 | $10 | $696.3K |
| 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. | 56,660 | $10 | $509.9K |
Showing 1–10 of 165
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
165 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0483 | 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… | 2 | 20 | 940 | $110 | $1.1M |
| 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… | 5 | 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… | 11 | 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)… | 20 | 80 | 530 | $130 | $505.1K |
| G0481 | 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… | 2 | 30 | 420 | $70 | $308.4K |
| G0482 | 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… | 2 | 10 | 2,430 | $70 | $286.5K |
| 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. | 3 | 280 | 1,120 | $30 | $218.9K |
| 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,… | 11 | 210 | 680 | $20 | $206.4K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 2 | 10 | 80 | $160 | $192K |
| 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… | 40 | 250 | 450 | $40 | $185.7K |
Showing 1–10 of 165
Other providers in the same ZIP code as Des Plaines Clinical Lab Inc, ranked by combined Medicare and Medicaid revenue.
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