Statistical flag only — not an accusation of fraud
This provider's $50.2M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 53% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 68/100. 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 | $53.08 | $13.35 | 3.98x | $39.73 | $4.0M | 298.4K | 99 |
| 2015 | $53.50 | $13.47 | 3.97x | $40.03 | $3.9M | 291.3K | 99 |
| 2016 | $54.23 | $13.67 | 3.97x | $40.56 | $4.5M | 331.0K | 102 |
| 2017 | $54.65 | $13.87 | 3.94x | $40.78 | $4.6M | 334.0K | 109 |
| 2018 | $55.40 | $13.65 | 4.06x | $41.75 | $4.8M | 355.3K | 114 |
| 2019 | $55.65 | $12.39 | 4.49x | $43.26 | $4.8M | 386.5K | 126 |
| 2020 | $58.29 | $13.05 | 4.47x | $45.24 | $4.5M | 341.6K | 126 |
| 2021 | $60.84 | $14.26 | 4.27x | $46.58 | $6.0M | 422.2K | 129 |
| 2022 | $61.96 | $14.94 | 4.15x | $47.02 | $7.0M | 465.2K | 135 |
| 2023 | $59.31 | $13.51 | 4.39x | $45.80 | $6.1M | 450.4K | 131 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 82306 | Vitamin d-3 level | 172.6K | $5.9M | $34.01 | 3.53x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 237.2K | $4.6M | $19.37 | 4.13x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 266.5K | $3.5M | $13.04 | 4.60x |
| 80053 | Blood test, comprehensive group of blood chemicals | 309.2K | $3.4M | $10.97 | 5.01x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 299.9K | $2.7M | $8.96 | 3.90x |
| 83036 | Hemoglobin a1c level | 200.2K | $2.2M | $11.12 | 4.50x |
| 87150 | Identification of organisms by genetic analysis, amplified probe technique | 60.2K | $2.1M | $34.70 | 2.88x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 56.1K | $1.9M | $34.70 | 2.88x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 99.1K | $1.7M | $17.21 | 4.36x |
| 84153 | Psa (prostate specific antigen) measurement, total | 55.4K | $1.2M | $21.19 | 4.25x |
| 82746 | Folic acid level, serum | 67.5K | $1.1M | $16.88 | 4.44x |
| 84439 | Thyroxine (thyroid chemical), free | 92.0K | $944.7K | $10.27 | 4.38x |
| 84481 | Thyroid hormone, t3 measurement, free | 45.4K | $890.7K | $19.62 | 4.08x |
| 82728 | Ferritin (blood protein) level | 50.9K | $793.4K | $15.59 | 4.81x |
| 86769 | Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody | 15.3K | $640.1K | $41.91 | 2.39x |
| 80074 | Acute hepatitis panel | 11.5K | $630.9K | $54.77 | 4.56x |
| 83540 | Iron level | 77.5K | $576.0K | $7.43 | 5.38x |
| 81001 | Manual urinalysis test with examination using microscope, automated | 153.7K | $560.0K | $3.64 | 4.12x |
| 84550 | Uric acid level, blood | 124.2K | $555.1K | $4.47 | 5.59x |
| 87086 | Bacterial colony count, urine | 56.9K | $532.0K | $9.34 | 3.75x |
This provider submits charges 4.18 times higher than what Medicare actually pays.
A markup ratio of 4.18x means for every $100 Medicare pays, this provider initially charges $418. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Genomic Health, Inc. | Redwood City, CA | $887.6M | ✓ Clear |
| Unilab Corporation | West Hills, CA | $868.8M | ⚠️ Flagged |
| Caredx Inc. | Brisbane, CA | $751.0M | ✓ Clear |
| Laboratory Corporation Of America | San Diego, CA | $592.4M | ⚠️ Flagged |
| Millennium Health, Llc | San Diego, CA | $587.9M | ✓ 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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