Statistical flag only — not an accusation of fraud
This provider's $20.1M in total Medicare payments ranks in the 95th percentile of Clinical Laboratory providers nationally.
This provider has been statistically flagged with a risk score of 70/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 526% in 2023
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 | $53.94 | $22.02 | 2.45x | $31.92 | $8.0M | 365.4K | 119 |
| 2015 | $65.80 | $13.36 | 4.93x | $52.44 | $1.7M | 128.9K | 120 |
| 2016 | $64.19 | $13.38 | 4.80x | $50.81 | $1.3M | 97.1K | 110 |
| 2017 | $62.37 | $13.03 | 4.79x | $49.34 | $882.3K | 67.7K | 87 |
| 2018 | $60.64 | $12.28 | 4.94x | $48.36 | $912.6K | 74.3K | 92 |
| 2019 | $59.66 | $10.93 | 5.46x | $48.73 | $751.3K | 68.7K | 86 |
| 2020 | $65.19 | $10.47 | 6.23x | $54.72 | $701.9K | 67.0K | 79 |
| 2021 | $66.44 | $10.66 | 6.23x | $55.78 | $698.1K | 65.5K | 82 |
| 2022 | $59.69 | $8.96 | 6.66x | $50.73 | $703.4K | 78.5K | 75 |
| 2023 | $48.47 | $8.00 | 6.06x | $40.47 | $4.4M | 550.8K | 80 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 26.4K | $2.5M | $95.70 | 1.67x |
| 80053 | Blood test, comprehensive group of blood chemicals | 110.5K | $1.2M | $10.83 | 4.12x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 67.2K | $1.0M | $15.19 | 5.75x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 44.5K | $913.2K | $20.52 | 4.61x |
| 82507 | Citrate level | 29.5K | $803.6K | $27.24 | 5.94x |
| 83925 | Opiates (drug) measurement | 30.3K | $784.9K | $25.89 | 1.88x |
| 82306 | Vitamin d-3 level | 19.2K | $707.3K | $36.92 | 6.09x |
| 80154 | Benzodiazepines level | 29.2K | $659.2K | $22.54 | 1.31x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 68.2K | $635.7K | $9.33 | 3.22x |
| 83840 | Methadone level | 29.2K | $634.0K | $21.74 | 1.75x |
| 82145 | Amphetamine or methamphetamine level | 29.2K | $603.5K | $20.70 | 1.76x |
| 82520 | Cocaine (drug) level | 29.2K | $588.9K | $20.19 | 1.77x |
| 82365 | Infrared analysis of stone | 42.1K | $537.3K | $12.78 | 7.58x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 70.0K | $423.4K | $6.05 | 4.65x |
| 82140 | Ammonia level | 29.4K | $420.3K | $14.29 | 5.94x |
| 82055 | Alcohol (ethanol) level | 29.2K | $419.9K | $14.37 | 1.72x |
| 83945 | Oxalate level | 29.4K | $416.0K | $14.16 | 5.91x |
| 87086 | Bacterial colony count, urine | 42.2K | $383.4K | $9.09 | 5.88x |
| 83036 | Hemoglobin a1c level | 26.9K | $326.3K | $12.11 | 5.31x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 32.4K | $300.8K | $9.29 | 4.36x |
This provider submits charges 4.34 times higher than what Medicare actually pays.
A markup ratio of 4.34x means for every $100 Medicare pays, this provider initially charges $434. 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 IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Llc Il | Wood Dale, IL | $446.2M | ⚠️ Flagged |
| Tempus Ai, Inc. | Chicago, IL | $213.4M | ⚠️ Flagged |
| Chicago Clinical Laboratories, Ltd | Northbrook, IL | $66.5M | ⚠️ Flagged |
| Lifescan Labs Of Illinois, Llc | Skokie, IL | $61.6M | ✓ Clear |
| Chicago Care Lab Services Llc | Chicago, IL | $56.7M | ⚠️ 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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