⚠️ This provider averages 2.2K services per working day — physically unusual for an individual practitioner
Based on 5.5M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $61.6M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Averaging 2.2K services per working day raises questions about billing patterns.
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 | $50.07 | $11.33 | 4.42x | $38.74 | $5.1M | 452.9K | 207 |
| 2015 | $50.47 | $11.51 | 4.38x | $38.96 | $5.6M | 486.3K | 213 |
| 2016 | $46.66 | $11.51 | 4.05x | $35.15 | $5.9M | 510.5K | 216 |
| 2017 | $46.61 | $11.41 | 4.09x | $35.20 | $6.3M | 549.0K | 228 |
| 2018 | $48.13 | $10.98 | 4.38x | $37.15 | $6.4M | 583.3K | 220 |
| 2019 | $49.83 | $9.91 | 5.03x | $39.92 | $5.8M | 588.9K | 202 |
| 2020 | $51.84 | $11.73 | 4.42x | $40.11 | $6.0M | 514.1K | 192 |
| 2021 | $54.90 | $11.80 | 4.65x | $43.10 | $7.0M | 592.2K | 197 |
| 2022 | $54.99 | $11.70 | 4.70x | $43.29 | $7.1M | 604.6K | 205 |
| 2023 | $57.75 | $10.94 | 5.28x | $46.81 | $6.4M | 586.6K | 214 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 433.5K | $5.0M | $11.61 | 5.50x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 315.5K | $4.4M | $14.00 | 5.51x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 219.5K | $4.3M | $19.39 | 4.98x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 459.6K | $4.1M | $8.91 | 5.06x |
| 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 | 48.9K | $4.0M | $81.55 | 1.23x |
| 36415 | Insertion of needle into vein for collection of blood sample | 1.0M | $3.6M | $3.52 | 3.77x |
| 82306 | Vitamin d-3 level | 104.1K | $3.6M | $34.60 | 3.40x |
| 83036 | Hemoglobin a1c level | 226.2K | $2.5M | $11.08 | 5.08x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 219.6K | $2.1M | $9.42 | 5.51x |
| 84153 | Psa (prostate specific antigen) measurement, total | 63.1K | $1.3M | $20.97 | 5.10x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 72.5K | $1.3M | $17.27 | 5.06x |
| 83970 | Parathormone (parathyroid hormone) level | 27.3K | $1.2M | $45.55 | 5.25x |
| 87086 | Bacterial colony count, urine | 110.5K | $1.0M | $9.31 | 5.04x |
| 82728 | Ferritin (blood protein) level | 53.6K | $827.2K | $15.44 | 5.19x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 18.0K | $741.5K | $41.19 | 5.11x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 34.0K | $725.6K | $21.33 | 4.11x |
| 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 | 28.9K | $718.3K | $24.81 | 1.03x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 66.7K | $666.9K | $9.99 | 5.54x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 104.7K | $616.7K | $5.89 | 5.39x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 72.8K | $544.2K | $7.47 | 3.93x |
This provider submits charges 4.55 times higher than what Medicare actually pays.
A markup ratio of 4.55x means for every $100 Medicare pays, this provider initially charges $455. 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.
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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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