Statistical flag only — not an accusation of fraud
This provider's $61.5M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 424% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 130% in 2016
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 | $156.66 | $19.51 | 8.03x | $137.15 | $1.8M | 93.6K | 92 |
| 2015 | $166.92 | $20.95 | 7.97x | $145.97 | $1.9M | 91.7K | 105 |
| 2016 | $192.51 | $54.24 | 3.55x | $138.27 | $4.4M | 81.6K | 97 |
| 2017 | $181.71 | $64.30 | 2.83x | $117.41 | $5.5M | 85.2K | 108 |
| 2018 | $182.04 | $57.96 | 3.14x | $124.08 | $4.6M | 79.3K | 103 |
| 2019 | $192.93 | $58.11 | 3.32x | $134.82 | $4.2M | 72.5K | 103 |
| 2020 | $190.79 | $81.30 | 2.35x | $109.49 | $8.6M | 105.4K | 105 |
| 2021 | $183.49 | $86.17 | 2.13x | $97.32 | $11.0M | 127.2K | 107 |
| 2022 | $188.80 | $86.01 | 2.20x | $102.79 | $9.9M | 115.3K | 99 |
| 2023 | $205.66 | $88.14 | 2.33x | $117.52 | $9.6M | 108.6K | 93 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80307 | Testing for presence of drug, by chemistry analyzers | 254.9K | $16.2M | $63.56 | 3.13x |
| 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 | 55.0K | $12.8M | $233.04 | 1.56x |
| G0480 | 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 | 112.7K | $11.5M | $102.11 | 2.10x |
| G0481 | 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 | 61.0K | $9.4M | $153.43 | 2.16x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 32.2K | $2.5M | $77.14 | 3.70x |
| 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 | 10.6K | $2.1M | $195.43 | 2.73x |
| G0434 | Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter | 60.6K | $1.2M | $19.40 | 13.22x |
| 83925 | Opiates (drug) measurement | 18.0K | $438.0K | $24.30 | 5.63x |
| 80053 | Blood test, comprehensive group of blood chemicals | 34.2K | $361.4K | $10.58 | 4.26x |
| G6056 | Opiate(s), drug and metabolites, each procedure | 14.8K | $360.8K | $24.44 | 5.55x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 16.6K | $322.1K | $19.35 | 4.63x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 22.4K | $317.2K | $14.13 | 5.75x |
| 82542 | Chemical analysis using chromatography technique | 11.5K | $276.0K | $24.06 | 4.97x |
| 82306 | Vitamin d-3 level | 7.5K | $253.6K | $33.93 | 5.93x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 2.5K | $241.1K | $96.49 | 3.39x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 24.9K | $222.9K | $8.96 | 3.33x |
| 80154 | Benzodiazepines level | 7.9K | $195.9K | $24.71 | 6.66x |
| G6031 | Benzodiazepines | 7.8K | $193.4K | $24.67 | 8.95x |
| 87902 | Analysis test by nucleic acid for hepatitis c virus | 956 | $182.4K | $190.79 | 3.45x |
| 83036 | Hemoglobin a1c level | 14.0K | $156.1K | $11.12 | 5.29x |
This provider submits charges 2.88 times higher than what Medicare actually pays.
A markup ratio of 2.88x means for every $100 Medicare pays, this provider initially charges $288. 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 NC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Laboratory Corporation Of America Holdings | Burlington, NC | $2.2B | ⚠️ Flagged |
| Pathgroup Labs, Llc | Greensboro, NC | $203.7M | ⚠️ Flagged |
| Mako Medical Laboratories, Llc | Raleigh, NC | $107.0M | ✓ Clear |
| Quest Diagnostics Clinical Laboratories Inc | Greensboro, NC | $69.3M | ⚠️ Flagged |
| Laboratory Corporation Of America Holdings | Research Triangle Park, NC | $65.4M | ✓ 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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