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NPI 1972625499 · Niles, IL · Clinical Medical Laboratory
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American Scientific Laboratory Inc is a clinical medical laboratory provider located in Niles, Illinois. This profile covers 58 Medicare and 112 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 | American Scientific Laboratory Inc |
| Address | 8744 N Shermer Rd |
| City | Niles |
| State | IL |
| ZIP | 60714 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 4, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $24M |
| Medicare | $482.2K |
Payer mix is heavily skewed toward Medicaid: the provider reported $482.2K in lifetime Medicare revenue versus $24M in lifetime Medicaid revenue, indicating Medicaid is the dominant revenue source by a wide margin. This makes the lab effectively a Medicaid-focused operation for scale and material revenue risk.
The practice has an established NPI tenure, enumerated on 2007-04-04 (~19 years ago), which supports a long-standing presence in the market and likely established collection, logistics, and reporting processes for high-volume lab work. Long tenure combined with the billing profile suggests an operational laboratory (not a new entrant).
Service-line mix and CPT footprint align with a high-throughput clinical diagnostics laboratory: top codes across payers include respiratory multiplex and nucleic-acid detection (87633, U0003, 87635), proprietary PLA testing (0223U), broad infectious-disease screening (86803, 86706, 87340), and routine chemistry/hematology/immunology panels (83970, 82306, 86141, 84443). The presence of 0223U (a PLA specific to QIAGEN’s QIAstat–Dx® Respiratory SARS CoV–2 Panel) and large claim volumes for multiplex respiratory and STD NAAT codes indicate a mix of proprietary/sequenced panel testing and standard serologic/chemistry services.
Medicare revenue concentration is modest but meaningful: the top three Medicare codes account for 26.5% of Medicare revenue, driven by 83970, 82306, and 86235 (PTH, vitamin D, and ENA antibody testing). Each of those codes posts above-median national rank/percentile (for example, 83970 ranks #170 of 3436, 95th percentile; 82306 ranks #307 of 12453, 98th percentile), indicating solid but not dominant national participation in these routine endocrine/immunology assays.
Medicaid revenue is more concentrated in a small set of high-volume tests: the top three Medicaid codes account for 31.1% of Medicaid revenue, led by 87633 (9.5K claims, $2.6M revenue), 0223U (4.3K claims, $1.6M revenue), and 83970 (43K claims, $1.1M revenue). Several of these Medicaid code rankings are described as "extreme outlier" or at the very top of state peers (for example, 87633 ranks #3 of 167 in-state, 99th percentile; 0223U ranks #1 of 1 providers in-state with no peer comparison), showing the lab is a major in-state source for respiratory and PTH testing.
Competitive standing differs sharply by payer: nationally for Medicare the provider generally appears as a high-percentile but not market-leading participant on many common assays (multiple codes in the 90–99th national percentiles but without top-10 national ranks), while in Illinois Medicaid the lab is a dominant statewide player on multiple assays. Examples of statewide dominance include 86141 (ranks #1 of 56 in-state, 100th percentile; labeled extreme outlier) and 84480 (ranks #1 of 99 in-state, 100th percentile; extreme outlier), plus numerous other codes at the 98–100th in-state percentiles.
Operational and business implications: the provider’s Medicaid-heavy revenue base and large volumes in a few Medicaid assays (including a PLA, 0223U) create sensitivity to Medicaid pricing, coverage policy, and contract changes for respiratory panels and high-volume routine tests such as 83970 and 86141. Conversely, the relatively small Medicare revenue pool ($482.2K) means Medicare policy shifts will have limited absolute revenue impact compared with Medicaid changes.
Public-health and payer program footprint is significant on infectious disease and STI screening: Medicaid claim volumes for targeted infectious tests are substantial (for example, 87633 9.5K claims, U0003 16.1K claims, 87591 19.9K claims, 87491 19.5K claims), indicating the lab services large-scale respiratory and STI screening programs or networks. This mix suggests the provider is positioned to serve high-throughput public health, clinic, or managed-care screening needs within the state.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
58 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 980 | $40 | $39.2K |
| 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… | 1,250 | $30 | $36.3K |
| 86235 | The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,… | 1,650 | $20 | $29.6K |
| 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… | 360 | $70 | $26.7K |
| 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… | 1,280 | $20 | $20.4K |
| 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… | 340 | $50 | $17.2K |
| 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. | 1,250 | $10 | $16.3K |
| 82728 | The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute… | 1,250 | $10 | $16.3K |
| 82785 | The lab analyst performs the technical lab test to analyze the quantity of immunoglobulin E in the specimen. | 970 | $20 | $15.5K |
| 86141 | The lab analyst performs the technical lab test to analyze the specimen, such as serum, for high sensitivity C reactive protein, hsCRP. | 1,180 | $10 | $15.3K |
Showing 1–10 of 58
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 58 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.
112 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 9,550 | $270 | $2.6M |
| 0223U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0223U for the… | 4,320 | $370 | $1.6M |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 42,990 | $30 | $1.1M |
| 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… | 16,140 | $60 | $1M |
| 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… | 64,050 | $10 | $832.6K |
| 86141 | The lab analyst performs the technical lab test to analyze the specimen, such as serum, for high sensitivity C reactive protein, hsCRP. | 59,440 | $10 | $832.1K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 19,950 | $40 | $718.1K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 19,480 | $40 | $701.2K |
| 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… | 12,870 | $50 | $630.7K |
| 86038 | The lab analyst performs the technical lab test to analyze for the presence of antinuclear antibodies in the serum; these are antibodies to the nucleus of a human cell. | 47,230 | $10 | $613.9K |
Showing 1–10 of 112
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
112 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 0223U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0223U for the… | 1 | 10 | 4,320 | $370 | $1.6M |
| 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… | 14 | 20 | 940 | $110 | $1.1M |
| 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… | 30 | 350 | 400 | $70 | $514.7K |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen… | 7 | 20 | 470 | $20 | $351.2K |
| 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… | 7 | 30 | 420 | $70 | $308.4K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 34 | 130 | 70 | $120 | $240.2K |
| 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. | 205 | 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,… | 30 | 210 | 680 | $20 | $206.4K |
| 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… | 3 | 170 | 150 | $200 | $190.9K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 70 | 110 | 150 | $40 | $184.1K |
Showing 1–10 of 112
Other providers in the same ZIP code as American Scientific Laboratory Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| 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 |
| Spectrum Lab Corp | IL | Clinical Medical Laboratory | $4.8M | $44.6K |
| 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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