Statistical flag only — not an accusation of fraud
This provider's $101.5M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
This provider has been statistically flagged with a risk score of 78/100. 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 | $20.22 | $14.50 | 1.39x | $5.72 | $7.3M | 506.5K | 162 |
| 2015 | $20.33 | $14.44 | 1.41x | $5.89 | $7.7M | 534.1K | 171 |
| 2016 | $21.22 | $14.99 | 1.42x | $6.23 | $8.9M | 595.1K | 177 |
| 2017 | $26.66 | $16.47 | 1.62x | $10.19 | $9.7M | 586.1K | 184 |
| 2018 | $24.28 | $16.38 | 1.48x | $7.90 | $10.6M | 648.1K | 199 |
| 2019 | $24.46 | $15.21 | 1.61x | $9.25 | $10.0M | 656.7K | 208 |
| 2020 | $34.67 | $19.24 | 1.80x | $15.43 | $12.7M | 659.0K | 199 |
| 2021 | $44.96 | $17.51 | 2.57x | $27.45 | $13.4M | 766.3K | 207 |
| 2022 | $168.54 | $16.35 | 10.31x | $152.19 | $11.7M | 714.8K | 203 |
| 2023 | $162.93 | $13.58 | 12.00x | $149.35 | $9.5M | 699.3K | 215 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 82306 | Vitamin d-3 level | 238.7K | $8.1M | $33.92 | 3.08x |
| 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 | 94.0K | $7.8M | $82.94 | 2.91x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 322.9K | $6.2M | $19.26 | 3.92x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 354.1K | $4.5M | $12.69 | 4.25x |
| 80053 | Blood test, comprehensive group of blood chemicals | 400.0K | $4.5M | $11.16 | 5.96x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 248.4K | $4.3M | $17.28 | 4.37x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 432.4K | $3.9M | $8.95 | 4.99x |
| 83036 | Hemoglobin a1c level | 321.3K | $3.6M | $11.08 | 3.81x |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 13.3K | $3.2M | $242.01 | 2.18x |
| 86769 | Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody | 68.7K | $2.9M | $41.93 | 2.27x |
| 82746 | Folic acid level, serum | 157.2K | $2.6M | $16.63 | 4.22x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 184.9K | $2.4M | $12.72 | 1.31x |
| 84481 | Thyroid hormone, t3 measurement, free | 105.1K | $2.0M | $19.26 | 6.37x |
| 84153 | Psa (prostate specific antigen) measurement, total | 93.4K | $2.0M | $21.25 | 3.12x |
| 81539 | Measurement of proteins associated with prostate cancer | 2.6K | $1.9M | $710.04 | 1.23x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 41.9K | $1.7M | $40.73 | 4.90x |
| 82728 | Ferritin (blood protein) level | 99.5K | $1.5M | $15.44 | 4.63x |
| 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 | 57.6K | $1.4M | $24.70 | 2.83x |
| 84439 | Thyroxine (thyroid chemical), free | 114.8K | $1.2M | $10.11 | 3.69x |
| 83540 | Iron level | 143.1K | $1.1M | $7.37 | 4.62x |
This provider submits charges 3.67 times higher than what Medicare actually pays.
A markup ratio of 3.67x means for every $100 Medicare pays, this provider initially charges $367. 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 |
| Enzo Clinical Labs, Inc. | Farmingdale, NY | $100.1M | ⚠️ 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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