Statistical flag only — not an accusation of fraud
This provider's $100.1M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 5.27x is significantly above the specialty median of 3.7x.
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 | $69.22 | $13.40 | 5.17x | $55.82 | $12.0M | 893.2K | 266 |
| 2015 | $69.43 | $13.72 | 5.06x | $55.71 | $11.8M | 858.5K | 273 |
| 2016 | $70.54 | $14.16 | 4.98x | $56.38 | $11.9M | 841.5K | 269 |
| 2017 | $71.21 | $14.35 | 4.96x | $56.86 | $11.9M | 827.0K | 274 |
| 2018 | $73.63 | $14.46 | 5.09x | $59.17 | $11.4M | 785.2K | 266 |
| 2019 | $74.38 | $13.38 | 5.56x | $61.00 | $11.0M | 820.8K | 268 |
| 2020 | $78.04 | $14.21 | 5.49x | $63.83 | $9.3M | 654.8K | 259 |
| 2021 | $77.80 | $14.02 | 5.55x | $63.78 | $9.3M | 664.8K | 251 |
| 2022 | $75.97 | $13.48 | 5.64x | $62.49 | $8.4M | 621.6K | 255 |
| 2023 | $73.54 | $12.78 | 5.75x | $60.76 | $3.2M | 249.1K | 190 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 82306 | Vitamin d-3 level | 259.8K | $9.2M | $35.48 | 5.50x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 411.6K | $8.3M | $20.06 | 5.39x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 479.3K | $7.1M | $14.82 | 6.07x |
| 80053 | Blood test, comprehensive group of blood chemicals | 623.2K | $6.3M | $10.14 | 4.27x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 590.5K | $5.5M | $9.28 | 4.29x |
| 83036 | Hemoglobin a1c level | 326.9K | $3.8M | $11.60 | 5.99x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 144.4K | $2.6M | $17.74 | 5.35x |
| 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 | 28.9K | $2.4M | $83.92 | 2.38x |
| 84439 | Thyroxine (thyroid chemical), free | 206.8K | $2.2M | $10.52 | 11.88x |
| 84153 | Psa (prostate specific antigen) measurement, total | 87.8K | $1.9M | $21.88 | 5.49x |
| 82746 | Folic acid level, serum | 109.7K | $1.9M | $17.32 | 5.77x |
| 88175 | Pap test, automated thin layer preparation; automated system and manual rescreening | 48.2K | $1.5M | $31.69 | 3.77x |
| 82728 | Ferritin (blood protein) level | 83.2K | $1.3M | $16.10 | 5.90x |
| 87086 | Bacterial colony count, urine | 139.2K | $1.3M | $9.50 | 6.83x |
| 87624 | Detection test by nucleic acid for human papillomavirus (hpv), high-risk types | 32.0K | $1.3M | $39.95 | 4.68x |
| 86141 | Measurement c-reactive protein for detection of infection or inflammation, high sensitivity | 86.2K | $1.3M | $14.55 | 5.84x |
| 83970 | Parathormone (parathyroid hormone) level | 25.8K | $1.2M | $48.37 | 5.21x |
| 36415 | Insertion of needle into vein for collection of blood sample | 354.9K | $1.1M | $3.19 | 5.65x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 26.3K | $975.8K | $37.07 | 2.17x |
| 86618 | Analysis for antibody borrelia burgdorferi (lyme disease bacteria) | 47.7K | $953.9K | $19.99 | 9.52x |
This provider submits charges 5.27 times higher than what Medicare actually pays.
A markup ratio of 5.27x means for every $100 Medicare pays, this provider initially charges $527. 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 |
| Cblpath, Inc | Rye Brook, NY | $94.4M | ✓ Clear |
| Cdx Diagnostics, Inc. | Suffern, NY | $84.1M | ✓ 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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