This provider's $90.8M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 373% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 106% in 2022
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 | $62.33 | $26.07 | 2.39x | $36.26 | $3.3M | 127.1K | 16 |
| 2015 | $61.37 | $26.37 | 2.33x | $35.00 | $4.5M | 168.8K | 17 |
| 2016 | $58.99 | $25.00 | 2.36x | $33.99 | $6.1M | 242.9K | 17 |
| 2017 | $58.98 | $23.51 | 2.51x | $35.47 | $7.9M | 335.0K | 21 |
| 2018 | $60.33 | $22.70 | 2.66x | $37.63 | $8.6M | 378.2K | 20 |
| 2019 | $61.89 | $20.17 | 3.07x | $41.72 | $9.6M | 474.8K | 20 |
| 2020 | $61.15 | $18.76 | 3.26x | $42.39 | $7.9M | 422.9K | 21 |
| 2021 | $62.57 | $18.71 | 3.34x | $43.86 | $8.9M | 478.2K | 26 |
| 2022 | $88.87 | $52.26 | 1.70x | $36.61 | $18.4M | 352.6K | 25 |
| 2023 | $106.97 | $57.10 | 1.87x | $49.87 | $15.7M | 274.3K | 23 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 0312U | Analysis of 8 igg autoantibodies and 2 cell-bound complement activation products associated with autoimmune disease, using enzyme-linked immunosorbent immunoassay (elisa), flow cytometry and indirect immunofluorescence in serum specimen or plasma and whole | 25.2K | $23.6M | $935.45 | 1.16x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 928.2K | $18.8M | $20.23 | 2.00x |
| 86147 | Cardiolipin antibody (tissue antibody) measurement | 312.4K | $8.1M | $26.01 | 1.58x |
| 86146 | Beta 2 glycoprotein 1 antibody (autoantibody) measurement | 311.9K | $8.1M | $26.01 | 1.58x |
| 88184 | Flow cytometry technique for dna or cell analysis, first marker | 92.7K | $5.5M | $59.44 | 4.20x |
| 88187 | Flow cytometry technique for dna or cell analysis, 2 to 8 markers | 94.1K | $3.7M | $39.73 | 5.03x |
| 83520 | Measurement of substance using immunoassay technique | 185.6K | $3.2M | $17.17 | 2.23x |
| 88185 | Flow cytometry technique for dna or cell analysis, each additional marker | 90.6K | $2.5M | $27.36 | 3.66x |
| 86148 | Phospholipid antibody (autoimmune antibody) measurement | 123.4K | $2.2M | $18.03 | 1.96x |
| 86800 | Thyroglobulin (thyroid protein) antibody measurement | 123.9K | $2.2M | $17.74 | 1.73x |
| 86376 | Microsomal antibodies (autoantibody) measurement | 123.7K | $2.0M | $16.22 | 1.88x |
| 86225 | Measurement of dna antibody, native or double stranded | 107.3K | $1.7M | $15.68 | 2.56x |
| 86200 | Measurement of antibody for rheumatoid arthritis assessment | 97.2K | $1.5M | $14.94 | 12.10x |
| 83516 | Analysis of substance using immunoassay technique, multiple step method | 120.9K | $1.4M | $11.68 | 11.28x |
| 86038 | Screening test for autoimmune disorder | 97.6K | $1.4M | $13.94 | 2.15x |
| 86039 | Measurement of antibody for assessment of autoimmune disorder, titer | 98.8K | $1.3M | $12.87 | 2.33x |
| 86431 | Rheumatoid factor level | 201.6K | $1.2M | $6.04 | 4.97x |
| 84999 | Chemistry procedures | 10.2K | $698.8K | $68.69 | 3.13x |
| 86160 | Measurement of complement (immune system proteins), antigen, | 55.4K | $695.9K | $12.56 | 3.99x |
| 83876 | Myeloperoxidase (white blood cell enzyme) measurement | 7.4K | $371.5K | $50.18 | 3.07x |
This provider submits charges 2.43 times higher than what Medicare actually pays.
A markup ratio of 2.43x means for every $100 Medicare pays, this provider initially charges $243. 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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