Loading...
NPI 1952384216 · Dakota Dunes, SD · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Dunes Medical Laboratories is a clinical medical laboratory provider located in Dakota Dunes, South Dakota. This profile covers 101 Medicare and 50 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 | Dunes Medical Laboratories |
| Address | 101 Tower Rd |
| City | Dakota Dunes |
| State | SD |
| ZIP | 57049 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 21, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $416.6K |
| Medicare | $303K |
DUNES MEDICAL LABORATORIES operates as a full-service clinical laboratory with a clear emphasis on high-volume routine chemistry and endocrine testing alongside standard microbiology and pathology services. Medicare activity highlights high claims for 80053 (3.2K claims, $31.7K revenue) and 80061 (2.3K claims, $29.4K revenue), while Medicaid shows even larger volumes for those same chemistry panels with 80053 at 8.5K claims ($59.5K revenue) and 80061 at 4.9K claims ($44.3K revenue). The presence of pathology code 88305 on both payers (Medicare: 1.3K claims, $32K revenue; Medicaid: 1.4K claims, $26.3K revenue) and immunostain codes 88342/88341 indicates the lab also handles surgical pathology work and ancillary immunohistochemistry. Medicaid activity further includes molecular infectious testing (U0003, 294 claims, $11.8K revenue), showing some engagement with high-throughput SARS-CoV-2 diagnostics during the pandemic period captured here.
Revenue concentration is moderate: the top 3 Medicare codes by revenue account for 36.4% of this provider's total Medicare revenue, and the top 3 Medicaid codes by revenue account for 38.1% of this provider's total Medicaid revenue. For Medicare, those top codes include 88305, 80053, and 80061; for Medicaid, the top three are 80053, 84443, and 80061, indicating that a relatively small set of routine chemistry and pathology codes drive a large share of each payer’s billed revenue. This concentration suggests operational focus on a stable set of core testing services rather than a highly diversified specialty menu.
Payer mix shows Medicaid-scale dominance in absolute dollars: reported lifetime Medicaid revenue is $416.6K compared with Medicare revenue of $303K, indicating the practice currently derives more total billed revenue from Medicaid than from Medicare. Given the larger claim volumes reported to Medicaid for high-turnover panels (e.g., 80053 at 8.5K claims), the business appears to be more Medicaid-levered by scale in the dataset shown rather than effectively single-payer. Analysts should treat the lab as a mid-sized regional Medicaid provider with a meaningful but smaller Medicare footprint.
National competitive standing on Medicare is mixed: the lab ranks at or above the 98th percentile nationally for common chemistry panels (80053 ranks #433 of 26416, 80061 ranks #352 of 21671) which signals notably high throughput on routine tests at a national scale, while surgical pathology and specialized molecular/pathology measures are more typical to modest. For example, 88305 ranks #2889 of 14580 (80th percentile) and immunostain code 88377 is much lower nationally (rank #546 of 616, 7th percentile), indicating the lab is not a national leader in complex molecular or advanced pathology testing. This profile suggests competitive strength in high-volume routine testing with limited national presence for advanced specialty assays.
In-state (Medicaid) competitive standing is strong for core services: 80053 ranks #3 of 66 providers in-state (97th percentile), 84443 ranks #2 of 34 (97th percentile), and 80061 ranks #2 of 39 (97th percentile), indicating the lab is one of the top state providers for CMP, TSH, and lipid panel testing. The lab also shows leadership in certain microbiology procedures in-state—87088 ranks #1 of 5 providers (100th percentile) and 87205 ranks #1 of 2 providers (100th percentile)—suggesting a dominant local role for urine culture interpretation and Gram/Giemsa staining services. These in-state ranks point to a material competitive footprint within South Dakota’s Medicaid network for both chemistry and selected microbiology offerings.
The revenue and claims pattern reflects a high-volume, low-unit-price operational model for routine diagnostics: Medicaid 80053 averages $7 avg paid/claim across 8.5K claims ($59.5K revenue) and Medicare 80053 averages $10 avg paid/claim across 3.2K claims ($31.7K revenue), while other common panels (80048, 85025, 83036) also show low per-claim payments with large claim counts. This combination of many claims at modest average payments implies margins and competitiveness will be sensitive to payer fee schedules and referral volume, rather than being driven by a small number of high-value tests. Stakeholders should interpret growth or contraction risks in light of dependence on throughput.
Tenure and stability: the provider’s NPI was enumerated on 2005-11-21 (~21 years ago), indicating a long-established operation in the market. That longevity, paired with the strong in-state standings for several core codes, suggests entrenched referral relationships for routine lab work within the regional health ecosystem. Analysts can reasonably expect operational continuity and existing contracts with local clinicians unless otherwise indicated.
Specialty and statistical outliers: while the lab is prominent for routine chemistries and certain microbiology services, several specialty pathology/molecular items are not a material revenue driver here. Notably, immunohistochemistry and advanced pathology testing show modest to low national presence (88342 ranks #2211 of 11370, 80th percentile; 88341 ranks #5623 of 10274, 45th percentile; 88377 ranks #546 of 616, 7th percentile), and molecular SARS-CoV-2 testing on Medicaid (U0003, 294 claims, $11.8K revenue, rank #12 of 26, 56th percentile) is present but not dominant. This mixed profile indicates a service mix centered on high-volume clinical chemistry and core microbiology with limited expansion into high-complexity specialty testing at scale.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
101 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,280 | $30 | $32K |
| 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. | 3,170 | $10 | $31.7K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 2,270 | $10 | $29.4K |
| 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… | 1,540 | $20 | $24.6K |
| 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… | 610 | $30 | $17K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1,700 | $10 | $13.6K |
| 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… | 1,630 | $10 | $13.1K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 230 | $50 | $11.5K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 190 | $50 | $8.8K |
| 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… | 940 | $10 | $7.5K |
Showing 1–10 of 101
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 101 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
50 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 8,510 | $10 | $59.5K |
| 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… | 4,960 | $10 | $49.6K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 4,920 | $10 | $44.3K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 910 | $40 | $34.4K |
| 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… | 5,480 | $10 | $27.4K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,390 | $20 | $26.3K |
| 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… | 1,350 | $20 | $25.6K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 3,350 | $10 | $20.1K |
| 87070 | The lab analyst performs the technical lab steps to culture a specimen from any source except urine, blood, or stool. This service involves aerobic culture, which refers to the presence of oxygen.… | 1,840 | $10 | $12.9K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 1,080 | $10 | $11.9K |
Showing 1–10 of 50
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
50 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… | 12 | 30 | 270 | $70 | $138.6K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 8 | 20 | 210 | $50 | $104.8K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 30 | 110 | 990 | $20 | $82.9K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 12 | 20 | 520 | $30 | $79.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 13 | 20 | 490 | $30 | $76.2K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 8 | 10 | 1,430 | $20 | $57.5K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 44 | 50 | 420 | $30 | $54.1K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 4 | 20 | 190 | $40 | $33.9K |
| 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. | 3 | 70 | 920 | $20 | $33.8K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 5 | 10 | 670 | $10 | $29.7K |
Showing 1–10 of 50
Other providers in the same ZIP code as Dunes Medical Laboratories, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Cnos PC | SD | Orthopaedic Surgery Physician | $0 | $3.6M |
| Dunes Dental 4 Kids, LLP | SD | Pediatric Dentistry | $0 | $3.3M |
| Chad Laurich | SD | Vascular Surgery Physician | $3.2M | $0 |
| Liem Som Oei Md PC | SD | Nephrology Physician | $0 | $2.4M |
| Ear Nose And Throat Consultants And Hearing Services Plc | SD | Otolaryngology Physician | $0 | $2.2M |
| Oral Surgery Assocates, P.C. | SD | Oral and Maxillofacial Surgery (Dentist) | $0 | $2.1M |
| Dunes Anesthesia PC | SD | Pain Medicine (Anesthesiology) Physician | $0 | $1.1M |
| Midlands Clinic, P.C. | SD | Specialist | $0 | $822.9K |
| Beth Bruening | SD | Ophthalmology Physician | $704.9K | $2.2K |
| Neal Khurana | SD | Vascular & Interventional Radiology Physician | $704.3K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.