This provider's $91.5M in total Medicare payments ranks in the 99th 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 78% 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 | $7.62 | $5.79 | 1.32x | $1.83 | $9.0M | 1.6M | 121 |
| 2015 | $8.00 | $6.12 | 1.31x | $1.88 | $8.8M | 1.4M | 120 |
| 2016 | $7.96 | $6.09 | 1.31x | $1.87 | $8.8M | 1.4M | 119 |
| 2017 | $8.40 | $6.16 | 1.36x | $2.24 | $7.9M | 1.3M | 123 |
| 2018 | $8.45 | $5.96 | 1.42x | $2.49 | $8.4M | 1.4M | 124 |
| 2019 | $8.41 | $5.48 | 1.53x | $2.93 | $9.1M | 1.7M | 118 |
| 2020 | $9.94 | $6.45 | 1.54x | $3.49 | $8.0M | 1.2M | 118 |
| 2021 | $14.84 | $11.36 | 1.31x | $3.48 | $14.2M | 1.3M | 119 |
| 2022 | $11.71 | $8.37 | 1.40x | $3.34 | $9.5M | 1.1M | 123 |
| 2023 | $8.14 | $6.58 | 1.24x | $1.56 | $7.7M | 1.2M | 115 |
| 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 | 143.7K | $11.1M | $77.44 | 1.10x |
| 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) | 1.9M | $9.8M | $5.29 | 1.14x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 834.9K | $7.5M | $8.98 | 1.47x |
| 80053 | Blood test, comprehensive group of blood chemicals | 639.9K | $7.3M | $11.33 | 1.44x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 300.2K | $5.9M | $19.68 | 1.46x |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 5.0M | $5.0M | $1.00 | 1.08x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 457.7K | $4.5M | $9.75 | 1.48x |
| 82306 | Vitamin d-3 level | 86.4K | $2.9M | $34.11 | 1.46x |
| 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 | 116.7K | $2.9M | $24.92 | 1.01x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 192.8K | $2.7M | $13.89 | 1.64x |
| 83036 | Hemoglobin a1c level | 188.3K | $2.1M | $11.31 | 1.46x |
| 87086 | Bacterial colony count, urine | 213.1K | $2.0M | $9.53 | 1.45x |
| 85610 | Blood test, clotting time | 409.3K | $2.0M | $4.93 | 1.39x |
| 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 | 642.3K | $1.7M | $2.60 | 1.08x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 209.6K | $1.6M | $7.76 | 1.43x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 38.8K | $1.6M | $41.48 | 2.69x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 144.0K | $1.5M | $10.22 | 1.45x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 78.7K | $1.4M | $17.61 | 1.46x |
| 87088 | Bacterial urine culture | 125.1K | $1.2M | $9.55 | 1.46x |
| 84439 | Thyroxine (thyroid chemical), free | 86.0K | $895.5K | $10.41 | 1.48x |
This provider submits charges 1.37 times higher than what Medicare actually pays.
A markup ratio of 1.37x means for every $100 Medicare pays, this provider initially charges $137. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Laboratory Corporation Of America Holdings | Raritan, NJ | $1.2B | ⚠️ Flagged |
| Quest Diagnostics Incorporated | Clifton, NJ | $927.2M | ⚠️ Flagged |
| Bioreference Health, Llc | Elmwood Park, NJ | $841.0M | ⚠️ Flagged |
| Accu Reference Medical Lab, Llc | Linden, NJ | $204.9M | ⚠️ Flagged |
| Siparadigm Llc | Pine Brook, NJ | $70.1M | ✓ 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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