This provider's $17.2M in total Medicare payments ranks in the 94th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 75% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $23.54 | $11.69 | 2.01x | $11.85 | $1.4M | 181.5K | 56.2K |
| 2015 | $24.25 | $12.19 | 1.99x | $12.06 | $1.5M | 177.7K | 58.5K |
| 2016 | $25.21 | $12.18 | 2.07x | $13.03 | $1.5M | 170.2K | 58.4K |
| 2017 | $33.32 | $12.55 | 2.65x | $20.77 | $1.5M | 164.3K | 60.8K |
| 2018 | $30.67 | $12.33 | 2.49x | $18.34 | $1.6M | 193.3K | 76.1K |
| 2019 | $17.43 | $11.13 | 1.57x | $6.30 | $2.0M | 248.7K | 96.3K |
| 2020 | $19.57 | $12.11 | 1.62x | $7.46 | $1.9M | 214.6K | 90.2K |
| 2021 | $19.13 | $11.23 | 1.70x | $7.90 | $1.7M | 208.8K | 89.9K |
| 2022 | $21.78 | $10.83 | 2.01x | $10.95 | $1.8M | 238.3K | 98.0K |
| 2023 | $21.66 | $10.78 | 2.01x | $10.88 | $2.4M | 275.3K | 120.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 415.8K | $2.4M | $5.67 | 1.76x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 261.8K | $2.3M | $8.67 | 1.72x |
| 80053 | Blood test, comprehensive group of blood chemicals | 148.1K | $1.7M | $11.58 | 2.07x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 60.5K | $1.1M | $18.99 | 2.22x |
| 80048 | Blood test, basic group of blood chemicals | 109.6K | $1.0M | $9.38 | 1.82x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge. | 287.2K | $839.0K | $2.92 | 1.02x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 52.6K | $709.1K | $13.49 | 2.01x |
| 83036 | Hemoglobin A1C level | 60.6K | $657.7K | $10.85 | 1.80x |
| 82652 | Dihydroxyvitamin D, 1, 25 level | 15.5K | $648.1K | $41.89 | 2.34x |
| 87086 | Bacterial colony count, urine | 48.1K | $442.8K | $9.21 | 2.19x |
| 84134 | Prealbumin (protein) level | 20.1K | $340.9K | $16.97 | 2.27x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 6.8K | $281.0K | $41.30 | 1.73x |
| 85610 | Blood test, clotting time | 57.8K | $280.3K | $4.85 | 1.55x |
| 87088 | Bacterial urine culture | 30.0K | $275.6K | $9.19 | 2.30x |
| 80164 | Dipropylacetic acid (valproic acid) level | 17.7K | $267.6K | $15.11 | 1.71x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 26.1K | $260.1K | $9.97 | 1.63x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 12.6K | $210.4K | $16.72 | 2.18x |
| 81001 | Manual urinalysis test with examination using microscope | 54.9K | $196.6K | $3.58 | 1.57x |
| 83735 | Magnesium level | 21.8K | $162.1K | $7.45 | 2.26x |
| 84439 | Thyroxine (thyroid chemical) measurement | 15.3K | $156.8K | $10.25 | 1.78x |
This provider submits charges 1.89 times higher than what Medicare actually pays.
A markup ratio of 1.89x means for every $100 Medicare pays, this provider initially charges $189. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Clinical Laboratory providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Genomic Health, Inc. | Redwood City, CA | $887.6M | ✓ Clear |
| Unilab Corporation | West Hills, CA | $868.8M | ⚠️ Flagged |
| Caredx Inc. | Brisbane, CA | $751.0M | ✓ Clear |
| Laboratory Corporation Of America | San Diego, CA | $592.4M | ⚠️ Flagged |
| Millennium Health, Llc | San Diego, CA | $587.9M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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