⚠️ This provider averages 249 services per working day — physically unusual for an individual practitioner
Based on 622.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $49.3M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Averaging 249 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 375% 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 | $327.52 | $72.36 | 4.53x | $255.16 | $1.4M | 19.7K | 16 |
| 2015 | $434.29 | $106.65 | 4.07x | $327.64 | $2.1M | 19.9K | 20 |
| 2016 | $496.07 | $135.49 | 3.66x | $360.58 | $2.9M | 21.5K | 19 |
| 2017 | $514.27 | $146.27 | 3.52x | $368.00 | $3.3M | 22.7K | 21 |
| 2018 | $461.57 | $132.80 | 3.48x | $328.77 | $4.4M | 33.1K | 28 |
| 2019 | $353.84 | $116.58 | 3.04x | $237.26 | $6.0M | 51.1K | 29 |
| 2020 | $242.13 | $81.47 | 2.97x | $160.66 | $6.1M | 75.4K | 32 |
| 2021 | $190.12 | $62.33 | 3.05x | $127.79 | $8.3M | 132.6K | 38 |
| 2022 | $186.13 | $60.43 | 3.08x | $125.70 | $8.0M | 132.1K | 37 |
| 2023 | $179.85 | $59.13 | 3.04x | $120.72 | $6.8M | 114.5K | 37 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87506 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets | 48.3K | $12.6M | $260.00 | 2.53x |
| 87507 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets | 20.3K | $9.9M | $487.55 | 2.63x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 52.8K | $4.4M | $82.69 | 2.59x |
| 88120 | Cell examination of urine, manual | 7.8K | $4.1M | $528.81 | 3.12x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 92.3K | $2.9M | $31.46 | 6.26x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 37.9K | $2.3M | $60.85 | 3.49x |
| 88344 | Special stained specimen slides to examine tissue, each multiplex procedure | 17.3K | $2.1M | $120.26 | 3.94x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 5.1K | $1.5M | $288.44 | 4.85x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 20.1K | $1.3M | $63.37 | 4.69x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 30.5K | $1.1M | $34.50 | 2.54x |
| 88112 | Cell examination of specimen, selective cellular enhancement technique | 27.8K | $1.0M | $36.55 | 6.11x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 13.9K | $1.0M | $72.26 | 4.01x |
| 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 | 35.9K | $894.2K | $24.88 | 2.51x |
| 83993 | Stool calprotectin (protein) level | 36.5K | $717.1K | $19.65 | 3.21x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 6.7K | $406.7K | $60.55 | 4.26x |
| 82656 | Detection of pancreatic elastase (enzyme) in stool | 32.6K | $376.4K | $11.55 | 3.29x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 2.6K | $365.2K | $139.77 | 2.57x |
| 87209 | Special stain for parasites | 17.0K | $310.3K | $18.29 | 3.33x |
| 81313 | Test for detecting genes associated with prostate cancer | 875 | $258.2K | $295.10 | 2.66x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 3.8K | $201.2K | $53.47 | 5.57x |
This provider submits charges 3.23 times higher than what Medicare actually pays.
A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. This is higher 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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