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NPI 1700466745 · Irvine, CA · Clinical Laboratory Director (Non-physician)
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Biognomics Lab, LLC is a clinical laboratory director (non-physician) provider located in Irvine, California. 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 | Biognomics Lab, LLC |
| Address | 16485 Laguna Canyon Rd Ste 125 |
| City | Irvine |
| State | CA |
| ZIP | 92618 |
| Taxonomy | Clinical Laboratory Director (Non-physician) |
| NPI Enumerated | April 13, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $16.4M |
| Medicaid | $235.6K |
This provider is heavily Medicare-focused in scale: it reports $16.4M in total Medicare revenue compared with $235.6K in total Medicaid revenue, so the Medicare book of business is orders of magnitude larger than Medicaid and the organization is effectively Medicare-dominated. The disparity indicates the provider’s principal commercial exposure and revenue dependency lies with Medicare billing rather than with state Medicaid programs.
Medicare revenue is extremely concentrated in a single activity: the top three Medicare codes account for 100.0% of total Medicare revenue, and K1034 alone is reported with $16.7M in revenue from 1.4M claims at an average paid/claim of $12. K1034 is described as provision of nonprescription, self‑administered COVID‑19 tests, so the practice’s Medicare operation appears to be primarily a high‑volume distributor/processor of over‑the‑counter COVID test products billed to Medicare.
On national competitive standing for its Medicare activity, the provider’s K1034 volume ranks #27 of 30143 providers nationally (100th percentile) and is labeled an "extreme outlier, far above typical national volume for this code." This places the entity among the very highest‑volume national billers for that specific COVID test code and indicates a dominant, specialized presence on that product line versus peers.
Medicaid billing is concentrated in laboratory testing and specimen services: U0003 contributes $177.1K (2.4K claims, $73 avg/claim) and G2023 contributes $43.9K (2K claims, $22 avg/claim), with U0003 + G2023 + U0005 comprising 97.2% of total Medicaid revenue. The presence of U0003 and U0005 (NAAT SARS‑CoV‑2 detection codes) alongside G2023 (specimen collection) suggests the Medicaid activity is primarily traditional laboratory testing and specimen management rather than retail distribution of self‑tests.
State‑level competitive signals for Medicaid are modest: U0003 ranks #242 of 751 providers in‑state (68th percentile) and G2023 ranks #159 of 497 (68th percentile), both described as typical, unremarkable volumes in California. By contrast, K1034 on Medicaid ranks #9 of 51 providers in‑state (84th percentile) but represents only $6.4K (2.7% of Medicaid revenue), indicating a relatively high state rank for the nonprescription test code but only a small share of the provider’s Medicaid revenue base.
The provider’s NPI was enumerated on 2021-04-13 (~5 years ago), which is temporally consistent with ramping or establishment during the COVID‑19 public health response. That timing, together with the product mix dominated by COVID‑19 test codes, supports an interpretation that the practice’s core business lines were organized around pandemic testing needs.
Concentration exposure is material: Medicare revenue is completely concentrated in the top three Medicare codes (100.0%), and Medicaid revenue is similarly concentrated with the top three Medicaid codes accounting for 97.2%. Those concentration metrics signal sensitivity to changes in reimbursement policy, coding rules, or demand for the specific COVID‑19 testing services that drive nearly all reported revenue.
Reimbursement mix and unit economics differ markedly across payers and codes: Medicare K1034 shows $12 avg paid/claim at very high volume, whereas Medicaid U0003 shows a much higher $73 avg paid/claim at lower claim counts. This contrast indicates Medicaid revenue is driven by higher‑unit lab NAAT payments while Medicare revenue is dominated by very large volumes of lower‑unit‑priced nonprescription self‑test billing.
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 |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,394,450 | $10 | $16.7M |
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 | 2,780 | 710 | $10 | $58.8K |
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… | 2,430 | $70 | $177.1K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,000 | $20 | $43.9K |
| 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,… | 510 | $20 | $8.6K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,270 | $10 | $6.4K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 50 | $10 | $370 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California 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… | 242 | 750 | 950 | $50 | $890K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 159 | 500 | 530 | $20 | $128.1K |
| 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,… | 256 | 520 | 470 | $10 | $116K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 9 | 50 | 120 | $1 | $3.4K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 332 | 490 | 140 | $1 | $2.9K |
Other providers in the same ZIP code as Biognomics Lab, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Mdxhealth, Inc. | CA | Clinical Medical Laboratory | $24M | $797.5K |
| Shoreline Diagnostics LLC | CA | Clinical Medical Laboratory | $6.2M | $9.6M |
| Agendia Inc | CA | Clinical Medical Laboratory | $10.2M | $5.1M |
| Cap Diagnostics LLC | CA | Clinical Medical Laboratory | $3.4M | $10.8M |
| Healthquest Esoterics Inc | CA | Clinical Medical Laboratory | $159K | $6.7M |
| Specialty Surgical Center Of Irvine LP | CA | Ambulatory Surgical Clinic/Center | $1.1M | $1.4M |
| Fang Yu | CA | Gastroenterology Physician | $121.8K | $2.1M |
| Emeritus Medical Technology LLC | CA | Clinical Medical Laboratory | $1.9M | $20.8K |
| Sandeep Thakkar | CA | Neurology Physician | $1.4M | $92.5K |
| Kenneth Tokita | CA | Radiation Oncology Physician | $1.3M | $0 |
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