This provider's $13.5M in total Medicare payments ranks in the 93th percentile of Clinical Laboratory providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 116% in 2021
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 | $151.90 | $58.66 | 2.59x | $93.24 | $2.0M | 66.0K | 31.6K |
| 2015 | $191.82 | $64.14 | 2.99x | $127.68 | $1.5M | 44.3K | 17.2K |
| 2016 | $656.04 | $152.47 | 4.30x | $503.57 | $1.7M | 13.5K | 6.7K |
| 2017 | $599.94 | $231.43 | 2.59x | $368.51 | $1.4M | 8.6K | 6.6K |
| 2018 | $319.86 | $196.34 | 1.63x | $123.52 | $1.5M | 11.3K | 6.7K |
| 2019 | $340.00 | $211.27 | 1.61x | $128.73 | $1.2M | 10.4K | 6.3K |
| 2020 | $235.94 | $152.69 | 1.55x | $83.25 | $544.6K | 5.7K | 2.9K |
| 2021 | $169.29 | $130.12 | 1.30x | $39.17 | $1.2M | 24.4K | 6.1K |
| 2022 | $258.00 | $195.81 | 1.32x | $62.19 | $1.6M | 32.0K | 4.6K |
| 2023 | $164.03 | $98.71 | 1.66x | $65.32 | $812.9K | 13.5K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 throughput technologies as described by cms-2020-01-r | 33.2K | $2.5M | $76.64 | 2.31x |
| 81226 | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants | 4.1K | $1.8M | $443.43 | 1.73x |
| G0480 | Drug test def 1-7 classes | 17.2K | $1.8M | $103.43 | 4.06x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 13.0K | $1.3M | $97.07 | 6.44x |
| 81225 | Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants | 4.1K | $1.2M | $286.53 | 1.73x |
| 80307 | Testing for presence of drug | 12.1K | $837.4K | $69.30 | 3.15x |
| 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, making use of high throughput technologies, completed within | 29.9K | $740.9K | $24.78 | 1.01x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 5.4K | $420.8K | $77.61 | 8.05x |
| 82649 | Dihydromorphinone (drug) level | 6.4K | $219.1K | $34.30 | 1.48x |
| 87636 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b | 1.5K | $215.7K | $139.78 | 1.60x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 8.5K | $197.9K | $23.34 | 2.79x |
| 82646 | Dihydrocodeinone (drug) measurement | 6.4K | $176.3K | $27.57 | 1.85x |
| 83925 | Opiates (drug) measurement | 6.4K | $165.3K | $25.98 | 2.89x |
| G6046 | Dihydromorphinone | 4.5K | $153.5K | $34.27 | 2.19x |
| 80154 | Benzodiazepines level | 5.7K | $141.2K | $24.70 | 3.04x |
| G6045 | Dihydrocodeinone | 4.4K | $120.8K | $27.53 | 2.74x |
| G6056 | Opiate(s), drug and metabolites, each procedure | 4.4K | $113.2K | $25.94 | 2.89x |
| 82003 | Acetaminophen level | 4.2K | $112.4K | $27.02 | 1.89x |
| 82145 | Amphetamine or methamphetamine level | 5.4K | $111.7K | $20.75 | 2.45x |
| G0481 | Drug test def 8-14 classes | 738 | $111.4K | $150.96 | 2.41x |
This provider submits charges 3.05 times higher than what Medicare actually pays.
A markup ratio of 3.05x means for every $100 Medicare pays, this provider initially charges $305. This is higher 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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