This provider's $11.0M in total Medicare payments ranks in the 91th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 77% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
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 | $16.89 | $16.02 | 1.05x | $0.87 | $787.5K | 71.4K | 39.6K |
| 2015 | $17.09 | $16.21 | 1.05x | $0.88 | $829.2K | 74.5K | 42.2K |
| 2016 | $18.36 | $17.59 | 1.04x | $0.77 | $894.2K | 79.2K | 44.9K |
| 2017 | $18.64 | $17.73 | 1.05x | $0.91 | $801.4K | 69.2K | 42.5K |
| 2018 | $18.63 | $16.55 | 1.13x | $2.08 | $894.0K | 79.1K | 46.7K |
| 2019 | $17.51 | $16.06 | 1.09x | $1.45 | $1.2M | 120.3K | 67.7K |
| 2020 | $16.41 | $16.12 | 1.02x | $0.29 | $1.3M | 110.0K | 66.3K |
| 2021 | $15.82 | $15.75 | 1.00x | $0.07 | $1.4M | 122.0K | 70.5K |
| 2022 | $15.99 | $15.73 | 1.02x | $0.26 | $1.4M | 124.4K | 71.3K |
| 2023 | $15.39 | $15.01 | 1.03x | $0.38 | $1.4M | 129.0K | 71.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 62.1K | $1.2M | $18.95 | 1.04x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 77.1K | $1.0M | $13.61 | 1.14x |
| 80053 | Blood test, comprehensive group of blood chemicals | 92.6K | $1.0M | $11.08 | 1.12x |
| 82306 | Vitamin D-3 level | 24.3K | $803.2K | $33.09 | 1.04x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 79.6K | $704.2K | $8.84 | 1.04x |
| 36415 | Insertion of needle into vein for collection of blood sample | 144.5K | $514.1K | $3.56 | 1.02x |
| 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 | 6.0K | $500.5K | $83.55 | 1.01x |
| 83036 | Hemoglobin A1C level | 44.8K | $487.1K | $10.87 | 1.04x |
| 84153 | PSA (prostate specific antigen) measurement | 17.4K | $359.6K | $20.69 | 1.04x |
| 82274 | Stool analysis for blood | 11.0K | $197.5K | $18.00 | 1.04x |
| 87088 | Bacterial urine culture | 21.6K | $196.5K | $9.10 | 1.04x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 11.6K | $193.6K | $16.63 | 1.03x |
| 81001 | Manual urinalysis test with examination using microscope | 54.1K | $179.3K | $3.32 | 1.04x |
| 84439 | Thyroxine (thyroid chemical) measurement | 17.3K | $173.0K | $10.00 | 1.03x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 22.9K | $162.7K | $7.10 | 1.04x |
| 83970 | Parathormone (parathyroid hormone) level | 2.6K | $114.5K | $44.86 | 1.03x |
| 87426 | Elisa detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 2.9K | $112.3K | $39.34 | 1.07x |
| 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. | 11.2K | $110.3K | $9.85 | 1.02x |
| 86328 | Ia nfct ab sarscov2 covid19 | 2.6K | $109.9K | $42.20 | 1.00x |
| 84436 | Thyroxine (thyroid chemical) measurement | 13.1K | $102.6K | $7.82 | 1.04x |
This provider submits charges 1.05 times higher than what Medicare actually pays.
A markup ratio of 1.05x means for every $100 Medicare pays, this provider initially charges $105. This is lower than the national average.
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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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