Statistical flag only — not an accusation of fraud
This provider's $50.5M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 5.55x is significantly above the specialty median of 3.7x.
This provider has been statistically flagged with a risk score of 69/100. Statistical flags are not accusations of fraud.
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 | $54.24 | $12.99 | 4.18x | $41.25 | $4.3M | 332.4K | 134 |
| 2015 | $52.28 | $13.26 | 3.94x | $39.02 | $4.0M | 298.5K | 138 |
| 2016 | $70.78 | $15.20 | 4.66x | $55.58 | $5.1M | 333.2K | 147 |
| 2017 | $132.38 | $22.68 | 5.84x | $109.70 | $6.6M | 290.9K | 149 |
| 2018 | $117.02 | $19.30 | 6.06x | $97.72 | $5.2M | 269.6K | 146 |
| 2019 | $125.81 | $18.99 | 6.63x | $106.82 | $5.1M | 266.3K | 152 |
| 2020 | $106.13 | $17.82 | 5.96x | $88.31 | $4.7M | 263.6K | 165 |
| 2021 | $105.84 | $18.10 | 5.85x | $87.74 | $5.5M | 302.0K | 162 |
| 2022 | $97.18 | $16.77 | 5.79x | $80.41 | $5.3M | 318.2K | 167 |
| 2023 | $92.23 | $15.45 | 5.97x | $76.78 | $4.8M | 311.1K | 170 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 34.3K | $8.3M | $242.16 | 9.18x |
| 82306 | Vitamin d-3 level | 108.8K | $3.7M | $34.32 | 4.78x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 143.9K | $2.8M | $19.49 | 4.96x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 153.7K | $2.0M | $13.26 | 5.72x |
| 80053 | Blood test, comprehensive group of blood chemicals | 192.0K | $2.0M | $10.56 | 5.67x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 114.6K | $2.0M | $17.48 | 4.76x |
| 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 | 105.9K | $1.9M | $17.98 | 1.15x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 193.3K | $1.8M | $9.08 | 4.83x |
| 82746 | Folic acid level, serum | 96.7K | $1.6M | $16.90 | 4.52x |
| 83036 | Hemoglobin a1c level | 134.3K | $1.5M | $11.16 | 4.93x |
| 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 | 15.7K | $1.2M | $78.98 | 3.23x |
| 80307 | Testing for presence of drug, by chemistry analyzers | 16.8K | $1.2M | $70.33 | 5.66x |
| 82728 | Ferritin (blood protein) level | 59.3K | $925.9K | $15.61 | 4.95x |
| 84439 | Thyroxine (thyroid chemical), free | 83.5K | $870.1K | $10.42 | 8.63x |
| 86769 | Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody | 20.0K | $839.1K | $41.98 | 4.36x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 20.2K | $834.8K | $41.24 | 4.30x |
| 82652 | Dihydroxyvitamin d, 1, 25 level | 15.6K | $723.0K | $46.37 | 4.70x |
| 84153 | Psa (prostate specific antigen) measurement, total | 33.4K | $718.0K | $21.49 | 4.85x |
| 84481 | Thyroid hormone, t3 measurement, free | 35.1K | $683.2K | $19.47 | 4.93x |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 3.2K | $613.3K | $193.21 | 8.88x |
This provider submits charges 5.55 times higher than what Medicare actually pays.
A markup ratio of 5.55x means for every $100 Medicare pays, this provider initially charges $555. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Northwell Health Laboratories | New Hyde Park, NY | $299.4M | ⚠️ Flagged |
| Sunrise Medical Laboratories, Inc. | Hicksville, NY | $281.2M | ⚠️ Flagged |
| Lenco Diagnostic Laboratories,inc. | Brooklyn, NY | $101.5M | ⚠️ Flagged |
| Enzo Clinical Labs, Inc. | Farmingdale, NY | $100.1M | ⚠️ Flagged |
| Cblpath, Inc | Rye Brook, NY | $94.4M | ✓ 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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