Statistical flag only — not an accusation of fraud
This provider's $203.7M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 134% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 67/100. 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 | $48.38 | $14.28 | 3.39x | $34.10 | $10.6M | 742.3K | 240 |
| 2015 | $49.09 | $14.50 | 3.39x | $34.59 | $14.0M | 968.3K | 269 |
| 2016 | $49.06 | $14.57 | 3.37x | $34.49 | $16.2M | 1.1M | 264 |
| 2017 | $49.35 | $14.80 | 3.33x | $34.55 | $18.7M | 1.3M | 280 |
| 2018 | $49.55 | $14.46 | 3.43x | $35.09 | $22.6M | 1.6M | 299 |
| 2019 | $49.21 | $13.01 | 3.78x | $36.20 | $24.4M | 1.9M | 304 |
| 2020 | $49.84 | $12.16 | 4.10x | $37.68 | $21.8M | 1.8M | 301 |
| 2021 | $50.36 | $12.34 | 4.08x | $38.02 | $25.2M | 2.0M | 310 |
| 2022 | $46.71 | $12.19 | 3.83x | $34.52 | $25.3M | 2.1M | 326 |
| 2023 | $46.37 | $11.90 | 3.90x | $34.47 | $24.8M | 2.1M | 318 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 1.9M | $19.5M | $10.53 | 3.05x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 1.0M | $19.0M | $18.70 | 3.76x |
| 82306 | Vitamin d-3 level | 572.9K | $18.8M | $32.89 | 3.77x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 1.2M | $16.7M | $13.71 | 4.10x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 1.4M | $12.0M | $8.60 | 3.24x |
| 83970 | Parathormone (parathyroid hormone) level | 216.4K | $9.9M | $45.74 | 3.78x |
| 83036 | Hemoglobin a1c level | 694.0K | $7.4M | $10.63 | 3.83x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 301.4K | $5.2M | $17.09 | 3.70x |
| 87086 | Bacterial colony count, urine | 540.1K | $4.9M | $9.00 | 3.76x |
| 84153 | Psa (prostate specific antigen) measurement, total | 219.9K | $4.4M | $20.09 | 3.84x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 178.8K | $3.7M | $20.93 | 3.68x |
| 84403 | Testosterone (hormone) level, total | 123.6K | $3.5M | $28.27 | 3.83x |
| 84439 | Thyroxine (thyroid chemical), free | 337.8K | $3.4M | $10.04 | 3.76x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 279.7K | $2.7M | $9.66 | 3.75x |
| 82728 | Ferritin (blood protein) level | 175.0K | $2.7M | $15.22 | 3.75x |
| 87077 | Bacterial culture for aerobic isolates | 293.3K | $2.6M | $9.02 | 3.75x |
| 82746 | Folic acid level, serum | 142.8K | $2.4M | $16.77 | 3.67x |
| 84481 | Thyroid hormone, t3 measurement, free | 127.9K | $2.4M | $18.66 | 3.80x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 120.1K | $2.4M | $19.82 | 3.79x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 289.7K | $2.1M | $7.24 | 3.75x |
This provider submits charges 3.71 times higher than what Medicare actually pays.
A markup ratio of 3.71x means for every $100 Medicare pays, this provider initially charges $371. 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 |
| 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 |
| Laboratory Corporation Of America Holdings | Research Triangle Park, NC | $61.5M | ⚠️ Flagged |
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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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