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NPI 1629732052 · Niles, IL · Clinical Medical Laboratory
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Spectrum Lab Corp is a clinical medical laboratory provider located in Niles, Illinois. This profile covers 3 Medicare and 3 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 | Spectrum Lab Corp |
| Address | 7958 N Waukegan Rd |
| City | Niles |
| State | IL |
| ZIP | 60714 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 22, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.8M |
| Medicaid | $44.6K |
This provider’s Medicare business dwarfs its Medicaid activity: lifetime Medicare revenue is $4.8M versus total Medicaid revenue of $44.6K, indicating Medicare is effectively the dominant payer for this entity. The scale difference suggests the organization’s contracted or reimbursed services are focused primarily on fee-for-service Medicare channels rather than state Medicaid programs.
Revenue is highly concentrated in a very small set of codes for both payers: the top three Medicare codes account for 100.0% of the provider’s total Medicare revenue, and the top three Medicaid codes account for 100.0% of the provider’s total Medicaid revenue. This concentration implies limited service-line diversity in billed procedures and a dependency on a narrow set of billable activities.
The code mix and taxonomy align with a laboratory operation heavily oriented toward COVID-19 testing and related specimen services: K1034 (provision of nonprescription self-administered COVID-19 tests), U0003 (NAAT for SARS-CoV-2), and G2023 (specimen collection for SARS-CoV-2) comprise the top billings. Given the provider’s listed taxonomy as a Clinical Medical Laboratory, these codes indicate its primary service line is testing distribution and processing rather than broader clinical laboratory panels.
K1034 dominates the Medicare picture: the provider reported 396.7K claims for K1034, $12 avg paid/claim, and $4.8M revenue — which represents 100.0% of its Medicare revenue and ranks #96 of 30143 providers nationally (100th percentile; extreme outlier). This rank and volume position SPECTRUM LAB CORP as a national outlier and a major volume processor/distributor specifically for K1034-style nonprescription COVID-19 test provisioning.
Other Medicare codes are negligible by comparison: U0003 and G2023 each show only 20 claims on Medicare with $1.5K and $460 in revenue respectively, and are characterized as typical, unremarkable volumes. Those low counts confirm that the Medicare footprint is overwhelmingly concentrated in K1034 activity rather than high-throughput laboratory NAAT testing or specimen collection billed to Medicare.
On Medicaid the top code is U0003 (448 claims, $73 avg paid/claim, $32.7K revenue), which accounts for 73.3% of this provider’s Medicaid revenue, with G2023 at 23.0% ($10.3K) and K1034 at 3.7% ($1.7K). In-state rankings for these Medicaid codes are middle-of-pack (e.g., U0003 ranks #173 of 350, 51th percentile), indicating the provider is a modest participant in state Medicaid COVID testing markets rather than a leading Medicaid lab.
The provider’s NPI was enumerated on 2021-10-22 (~5 years ago), a relatively recent start date; combined with the outsized K1034 volumes reported on Medicare, this pattern suggests rapid scale-up focused on pandemic-era test provisioning. The recent tenure plus extreme national ranking on K1034 implies growth driven by COVID-19 test distribution rather than long-established, diversified laboratory billing relationships.
Operational and reimbursement sensitivity is a material business consideration: because 100.0% of Medicare revenue is driven by the top three codes (with K1034 alone generating the full Medicare revenue total), changes in policy or reimbursement for nonprescription COVID-19 tests or related billing rules could disproportionately affect overall revenue. Similarly, the small absolute Medicaid revenue ($44.6K) means state-level policy shifts would have limited immediate Medicaid downside but do not offset Medicare concentration risk.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 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 | 396,700 | $10 | $4.8M |
| 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… | 20 | $70 | $1.5K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 20 | $20 | $460 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
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.
3 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… | 450 | $70 | $32.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 450 | $20 | $10.3K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 830 | $1 | $1.7K |
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
3 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… | 173 | 350 | 400 | $70 | $514.7K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 208 | 400 | 550 | $20 | $90.8K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 27 | 60 | 660 | $1 | $3.2K |
Other providers in the same ZIP code as Spectrum Lab Corp, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| American Scientific Laboratory Inc | IL | Clinical Medical Laboratory | $482.2K | $24M |
| Ace Medical Supply LLC | IL | Durable Medical Equipment & Medical Supplies | $0 | $10.3M |
| Village Of Niles | IL | Land Ambulance | $595.4K | $8.3M |
| Hannan Lab Inc | IL | Clinical Medical Laboratory | $7.4M | $209.9K |
| Kingsway Home Health Services,inc | IL | Home Health Agency | $0 | $7.3M |
| Rumya Rao | IL | Retina Specialist (Ophthalmology) Physician | $1.7M | $2M |
| Matthew Wessel | IL | Retina Specialist (Ophthalmology) Physician | $2.3M | $1.3M |
| Asian Human Services Family Health Center, Inc | IL | Federally Qualified Health Center (FQHC) | $0 | $3.4M |
| John Eklund | IL | Hematology & Oncology Physician | $1.3M | $8.4K |
| Care One Pharmacy Services LLC | IL | Long Term Care Pharmacy | $262.5K | $856.9K |
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