Statistical flag only — not an accusation of fraud
This provider's $382.6M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 683% from 2014 to 2023.
69% of their billing comes from a single procedure code (81479 — Molecular pathology procedure).
This provider has been statistically flagged with a risk score of 71/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 180% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $734.98 | $159.05 | 4.62x | $575.93 | $12.4M | 78.2K | 20 |
| 2015 | $1.0K | $203.22 | 5.08x | $829.82 | $9.1M | 44.8K | 19 |
| 2016 | $1.8K | $189.05 | 9.75x | $1.7K | $5.4M | 28.7K | 10 |
| 2017 | $556.43 | $162.60 | 3.42x | $393.83 | $9.4M | 57.6K | 12 |
| 2018 | $522.29 | $298.90 | 1.75x | $223.39 | $26.2M | 87.7K | 11 |
| 2019 | $479.83 | $307.70 | 1.56x | $172.13 | $37.2M | 120.9K | 10 |
| 2020 | $449.24 | $332.28 | 1.35x | $116.96 | $51.9M | 156.3K | 8 |
| 2021 | $468.22 | $338.35 | 1.38x | $129.87 | $60.7M | 179.3K | 8 |
| 2022 | $459.81 | $355.99 | 1.29x | $103.82 | $72.9M | 204.8K | 9 |
| 2023 | $514.60 | $477.49 | 1.08x | $37.11 | $97.4M | 204.0K | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81479 | Molecular pathology procedure | 88.3K | $264.4M | $3.0K | 1.20x |
| 88360 | Microscopic genetic analysis of tumor, manual | 462.6K | $36.2M | $78.17 | 1.99x |
| 81455 | Test for detecting genes associated with cancer | 11.7K | $22.7M | $1.9K | 2.31x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 301.2K | $16.5M | $54.87 | 1.87x |
| 88381 | Preparation of specimen, manual | 92.3K | $9.6M | $104.59 | 2.28x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 102.1K | $6.5M | $63.63 | 1.80x |
| 81404 | Molecular pathology procedure level 5 | 21.6K | $5.8M | $267.83 | 5.97x |
| 88377 | Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure | 23.2K | $5.4M | $231.61 | 3.10x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 2.2K | $4.6M | $2.1K | 1.48x |
| 81235 | Gene analysis (epidermal growth factor receptor), common variants | 5.8K | $1.9M | $322.75 | 8.03x |
| 88368 | Microscopic genetic analysis of tissue | 12.2K | $1.8M | $144.14 | 3.19x |
| 81301 | Microsatellite instability analysis | 3.3K | $1.2M | $375.91 | 3.10x |
| 81210 | Gene analysis (v-raf murine sarcoma viral oncogene homolog B1) | 6.0K | $1.1M | $175.43 | 8.71x |
| 81245 | Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants | 5.5K | $892.1K | $162.38 | 2.46x |
| 81445 | Test for detecting genes associated with cancer of body organ | 2.0K | $884.1K | $445.18 | 32.79x |
| 88374 | Microscopic genetic examination using computer-assisted technology | 4.1K | $629.2K | $153.40 | 5.69x |
| 88365 | Genetic sequencing localization, initial procedure | 5.1K | $550.5K | $107.19 | 1.64x |
| 81403 | Molecular pathology procedure level 4 | 3.3K | $367.8K | $111.98 | 8.91x |
| 81275 | Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13 | 1.8K | $341.8K | $193.32 | 7.90x |
| 81405 | Molecular pathology procedure level 6 | 691 | $253.5K | $366.90 | 4.11x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. 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 AZ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sonora Quest Laboratories Llc | Phoenix, AZ | $565.3M | ⚠️ Flagged |
| Laboratory Corporation Of America | Phoenix, AZ | $389.8M | ⚠️ Flagged |
| Castle Biosciences, Inc | Phoenix, AZ | $258.8M | ✓ Clear |
| Genetic Technological Innovations, Llc | Scottsdale, AZ | $93.5M | ⚠️ Flagged |
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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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