Statistical flag only — not an accusation of fraud
This provider's $45.5M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 257% from 2020 to 2023.
This provider has been statistically flagged with a risk score of 78/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 358% 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 |
|---|---|---|---|---|---|---|---|
| 2020 | $21.68 | $16.93 | 1.28x | $4.75 | $3.4M | 201.9K | 204 |
| 2021 | $19.30 | $16.18 | 1.19x | $3.12 | $15.6M | 966.5K | 325 |
| 2022 | $91.12 | $15.66 | 5.82x | $75.46 | $14.3M | 910.7K | 328 |
| 2023 | $96.07 | $13.95 | 6.89x | $82.12 | $12.2M | 875.6K | 338 |
| 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 | 84.1K | $6.5M | $77.19 | 1.01x |
| 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 | 72.5K | $1.7M | $23.76 | 1.01x |
| 81528 | Gene analysis (colorectal cancer) | 3.3K | $1.7M | $502.70 | 1.32x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 197.5K | $1.5M | $7.66 | 6.10x |
| 86833 | Assessment of antibody to human leukocyte antigens (hla) with high definition qualitative panel for identification of antibody specificities, hla class ii | 4.6K | $1.4M | $296.11 | 2.06x |
| 86832 | Assessment of antibody to human leukocyte antigens (hla) with high definition qualitative panel for identification of antibody specificities, hla class i | 4.6K | $1.4M | $294.94 | 2.37x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 67.3K | $1.1M | $16.61 | 5.60x |
| 36415 | Insertion of needle into vein for collection of blood sample | 219.9K | $1.0M | $4.59 | 4.42x |
| 80053 | Blood test, comprehensive group of blood chemicals | 91.6K | $952.7K | $10.41 | 7.09x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 17.3K | $669.6K | $38.66 | 3.59x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 50.3K | $663.6K | $13.19 | 5.94x |
| 82306 | Vitamin d-3 level | 22.4K | $652.4K | $29.18 | 5.34x |
| 84153 | Psa (prostate specific antigen) measurement, total | 34.2K | $621.8K | $18.16 | 5.68x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 73.0K | $609.7K | $8.35 | 7.40x |
| 83970 | Parathormone (parathyroid hormone) level | 14.3K | $578.1K | $40.40 | 5.47x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 9.8K | $538.2K | $54.86 | 4.92x |
| 88185 | Flow cytometry technique for dna or cell analysis, each additional marker | 29.0K | $532.6K | $18.36 | 5.37x |
| 82565 | Blood creatinine level | 102.3K | $517.8K | $5.06 | 4.70x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 29.3K | $515.2K | $17.60 | 3.61x |
| 82784 | Gammaglobulin (immune system protein) measurement | 55.8K | $512.9K | $9.19 | 6.71x |
This provider submits charges 4.18 times higher than what Medicare actually pays.
A markup ratio of 4.18x means for every $100 Medicare pays, this provider initially charges $418. 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 MN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Mayo Collaborative Services, Inc | Rochester, MN | $63.5M | ⚠️ 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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