Statistical flag only — not an accusation of fraud
This provider's $93.5M 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 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 272% in 2020
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 | $667.86 | $217.64 | 3.07x | $450.22 | $20.8M | 95.7K | 6 |
| 2015 | $300.12 | $90.81 | 3.30x | $209.31 | $15.0M | 165.5K | 23 |
| 2016 | $1.9K | $100.72 | 18.60x | $1.8K | $1.9M | 18.6K | 26 |
| 2017 | $3.8K | $185.50 | 20.61x | $3.6K | $993.6K | 5.4K | 5 |
| 2018 | $2.4K | $137.02 | 17.26x | $2.2K | $730.3K | 5.3K | 26 |
| 2019 | $304.86 | $79.35 | 3.84x | $225.51 | $2.5M | 31.8K | 28 |
| 2020 | $172.19 | $48.22 | 3.57x | $123.97 | $9.4M | 194.7K | 35 |
| 2021 | $155.66 | $47.54 | 3.27x | $108.12 | $8.6M | 179.9K | 26 |
| 2022 | $84.25 | $42.90 | 1.96x | $41.35 | $12.1M | 281.5K | 39 |
| 2023 | $51.08 | $32.94 | 1.55x | $18.14 | $21.5M | 653.4K | 54 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81226 | Gene analysis (cytochrome p450, family 2, subfamily d, polypeptide 6) common variants | 39.6K | $17.5M | $442.09 | 2.88x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 427.5K | $14.9M | $34.80 | 2.43x |
| 81225 | Gene analysis (cytochrome p450, family 2, subfamily c, polypeptide 19) common variants | 37.4K | $10.7M | $285.65 | 3.33x |
| 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 | 29.9K | $7.2M | $242.28 | 5.74x |
| 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 | 84.3K | $6.7M | $79.26 | 3.15x |
| 87150 | Identification of organisms by genetic analysis, amplified probe technique | 137.4K | $4.7M | $34.39 | 1.45x |
| 81241 | Gene analysis (coagulation factor V) Leiden variant | 28.5K | $2.3M | $81.59 | 2.89x |
| 81240 | Gene analysis (prothrombin, coagulation factor II) A variant | 28.5K | $1.9M | $65.69 | 1.91x |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 157.7K | $1.9M | $11.76 | 1.53x |
| 81291 | Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants | 28.7K | $1.7M | $58.30 | 4.75x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 11.8K | $1.1M | $95.55 | 1.57x |
| G0481 | 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 | 8.6K | $1.1M | $129.41 | 22.62x |
| 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 | 42.4K | $1.0M | $24.74 | 1.01x |
| 87496 | Detection test by nucleic acid for cytomegalovirus (cmv), amplified probe technique | 27.9K | $970.6K | $34.76 | 2.68x |
| 87532 | Detection test by nucleic acid for herpes virus-6, amplified probe technique | 27.7K | $961.3K | $34.76 | 2.67x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 26.1K | $905.2K | $34.72 | 2.01x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 25.7K | $891.0K | $34.73 | 2.04x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 25.4K | $880.0K | $34.62 | 1.83x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 24.5K | $849.0K | $34.62 | 1.85x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 24.4K | $844.3K | $34.62 | 1.84x |
This provider submits charges 3.31 times higher than what Medicare actually pays.
A markup ratio of 3.31x means for every $100 Medicare pays, this provider initially charges $331. 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 AZ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sonora Quest Laboratories Llc | Phoenix, AZ | $565.3M | ⚠️ Flagged |
| Laboratory Corporation Of America | Phoenix, AZ | $389.8M | ⚠️ Flagged |
| Caris Mpi, Inc. | Phoenix, AZ | $382.6M | ⚠️ Flagged |
| Castle Biosciences, Inc | Phoenix, AZ | $258.8M | ✓ 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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