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NPI 1831612670 · Overland Park, KS · Clinical Medical Laboratory
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4m Healthcare, LLC is a clinical medical laboratory provider located in Overland Park, Kansas. This profile covers 33 Medicare and 69 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 | 4m Healthcare, LLC |
| Address | 15110 Glenwood Ave |
| City | Overland Park |
| State | KS |
| ZIP | 66223 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 24, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.7M |
| Medicare | $1.3M |
4M HEALTHCARE, LLC is registered as a Clinical Medical Laboratory and has been enumerated with an NPI since 2017-07-24 (~9 years ago), indicating several years of operational history. Its billing mix is dominated by definitive drug testing and molecular infectious‑disease assays, which aligns with the Clinical Medical Laboratory taxonomy and the specific high-volume CPT/HCPCS codes reported. This suggests the lab operates both high-throughput molecular testing workflows and toxicology panels as core service lines.
Medicare revenue is concentrated: the precomputed top‑3 Medicare codes account for 76.9% of the provider's Medicare revenue, driven primarily by G0483 ($635.3K, 49.5% of Medicare revenue), 87631 ($184.5K, 14.4%), and 87798 ($166.6K, 13.0%). This concentration indicates that a small set of high-value molecular and definitive drug‑testing services generate the bulk of Medicare billings. Analysts should view changes in utilization or reimbursement for these codes as having outsized impact on overall Medicare cash flow.
Medicaid revenue shows a similar concentration pattern: the precomputed top‑3 Medicaid codes account for 73.2% of Medicaid revenue, with U0003 contributing $598.3K (39.2%), G0483 $321.2K (21.0%), and 87798 $197.9K (13.0%). The Medicaid profile is weighted toward high-volume SARS‑CoV‑2 nucleic‑acid testing (U0003) plus definitive toxicology, indicating the provider captures substantial pandemic‑era and toxicology testing demand in the state. Given these three codes account for nearly three quarters of Medicaid revenue, payer negotiations or policy changes targeting those services would materially affect the provider’s Medicaid performance.
On payer mix, lifetime totals show Total Medicare revenue: $1.3M versus Total Medicaid revenue: $1.7M, so Medicaid is the larger single payer revenue source for this provider. That tilt toward Medicaid revenue—combined with the heavy Medicaid volume in U0003 and G0483—means the lab’s near‑term revenue is more sensitive to state program utilization and reimbursement policies than to Medicare alone. For network and procurement teams, this suggests prioritizing engagement with state Medicaid programs and managed‑care organizations.
Competitively, the provider posts above‑typical national standing on several Medicare codes: G0483 ranks #38 of 1063 nationally (97th percentile) and is characterized as typical, unremarkable volume for the code, while 87631 ranks #20 of 636 nationally (97th percentile) indicating nationally strong placement for respiratory/multiplex molecular testing. Other Medicare codes (for example, 87798 at #221 of 1319, 83rd percentile) show solid but less dominant positions. Overall, 4M HEALTHCARE is a high‑volume participant nationally on its core molecular and toxicology tests but less prominent across broader laboratory panels.
Within Kansas Medicaid, the provider is a leading in‑state performer on key services: G0483 ranks #1 of 6 providers in‑state (100th percentile; notably above typical state volume) and G0482 and several drug‑panel codes also rank at or near the top in‑state. U0003 ranks #6 of 47 in‑state (89th percentile) and 87798 ranks #3 of 31 (93rd percentile), reflecting that the lab is a major state participant for COVID molecular testing and other amplified‑probe services. These high in‑state ranks indicate market leadership on both definitive toxicology and high‑throughput molecular testing within Kansas.
The operational footprint implied by claims counts reinforces the service‑line view: for example, G0483 appears on 2.6K Medicare claims and 4.6K Medicaid claims, and U0003 shows 951 Medicare claims versus 15.3K Medicaid claims. This mismatch—especially the very large Medicaid volume for U0003—suggests the lab operates high‑throughput workflows tuned to state Medicaid demand (including pandemic testing) while maintaining substantial definitive toxicology capacity across both payers. Analysts should monitor specimen flow, capacity, and payer mix shifts for these high‑volume codes.
Several codes are flagged as statistical outliers in the provided comparisons and merit attention for business planning rather than compliance implication: Medicaid G0483 is noted as notably above typical state volume (100th percentile), and multiple Medicaid drug‑panel and drug‑specific detections (e.g., G0482, 80366, 80360) are ranked at or near the top in‑state. On Medicare, high percentile ranks for G0483 and 87631 (both 97th percentile) indicate unusually strong national placement for those services. These labels identify where the provider is an outlier in utilization relative to peers and therefore where revenue and operational risk or opportunity are concentrated.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
33 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 2,650 | $240 | $635.3K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 1,320 | $140 | $184.5K |
| 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… | 4,900 | $30 | $166.6K |
| 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… | 950 | $70 | $70.4K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,150 | $30 | $39K |
| 87529 | The lab analyst performs a test for Herpes simplex virus, HSV, using amplified nucleic acid probe technique. HSV causes clusters of blisters, or vesicles, on different parts of the body and spreads… | 750 | $30 | $25.5K |
| 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,… | 930 | $30 | $23.1K |
| 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… | 180 | $110 | $20K |
| 87556 | The lab analyst performs a test for Mycobacterium tuberculosis using amplified nucleic acid probe technique. Mycobacteria tuberculosis are sometimes called acid fast bacteria because of the special… | 380 | $40 | $15.4K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 380 | $30 | $12.8K |
Showing 1–10 of 33
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
33 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G0483 | 1 | 10 | 440 | $240 | $248.4K |
| G0480 | 2 | 10 | 140 | $110 | $160.3K |
| 87631 | 1 | 10 | 670 | $140 | $93.7K |
| 87798 | 3 | 10 | 220 | $30 | $58K |
| U0003 | 3 | 10 | 490 | $70 | $53.4K |
| 80307 | 16 | 20 | 220 | $60 | $46.9K |
| P9603 | 6 | 10 | 6,890 | $1 | $39.9K |
| 82306 | 149 | 160 | 40 | $30 | $27.1K |
| 84443 | 106 | 270 | 100 | $20 | $23.3K |
| 80053 | 167 | 350 | 150 | $10 | $18.6K |
Showing 1–10 of 33
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.
69 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… | 15,340 | $40 | $598.3K |
| 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… | 4,590 | $70 | $321.2K |
| 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… | 1,420 | $140 | $197.9K |
| 87505 | The lab analyst performs a test to detect three to five types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal… | 740 | $60 | $45.7K |
| 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… | 1,220 | $40 | $43.9K |
| 80355 | The lab analyst measures the amount of or detects the presence of gabapentin in the patient specimen, which is something other than blood. | 2,450 | $10 | $24.5K |
| 80366 | The lab analyst measures the amount of or detects the presence of pregabalin, a drug that treats nerve pain and seizures, in a patient specimen. | 2,300 | $10 | $23K |
| 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… | 940 | $20 | $22.5K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 1,030 | $20 | $18.6K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 1,000 | $20 | $17.9K |
Showing 1–10 of 69
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
69 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… | 6 | 50 | 300 | $60 | $648.3K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 16 | 60 | 280 | $30 | $295.1K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 20 | 60 | 230 | $30 | $292K |
| 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… | 3 | 10 | 180 | $50 | $273.4K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 6 | 30 | 280 | $20 | $231.6K |
| 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… | 3 | 10 | 4,030 | $50 | $185K |
| 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… | 1 | 10 | 420 | $90 | $115.8K |
| 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,… | 9 | 30 | 570 | $20 | $112.7K |
| 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… | 6 | 30 | 80 | $320 | $57K |
| 87505 | The lab analyst performs a test to detect three to five types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal… | 1 | 10 | 740 | $60 | $45.5K |
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Other providers in the same ZIP code as 4m Healthcare, LLC, ranked by combined Medicare and Medicaid revenue.
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