This provider's $20.0M in total Medicare payments ranks in the 95th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 12074% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 3546% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $300.00 | $100.00 | 3.00x | $200.00 | $66.6K | 666 | 1 |
| 2021 | $197.41 | $52.20 | 3.78x | $145.21 | $2.4M | 46.5K | 2 |
| 2022 | $166.38 | $46.07 | 3.61x | $120.31 | $9.4M | 203.0K | 13 |
| 2023 | $95.98 | $37.72 | 2.54x | $58.26 | $8.1M | 215.0K | 17 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 125.8K | $9.3M | $74.18 | 4.04x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 134.2K | $4.6M | $34.40 | 2.25x |
| 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 | 115.1K | $2.8M | $24.67 | 3.04x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 42.1K | $1.4M | $34.40 | 2.24x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 10.1K | $349.0K | $34.41 | 2.18x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 10.0K | $342.7K | $34.41 | 2.18x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 9.7K | $334.9K | $34.40 | 2.15x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 7.8K | $269.6K | $34.41 | 2.22x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 1.7K | $83.0K | $50.28 | 3.06x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 1.9K | $65.7K | $34.40 | 2.18x |
| 87471 | Detection by nucleic acid bartonella henselae and bartonella quintana (bacteria), amplified probe technique | 1.6K | $56.3K | $34.40 | 2.16x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 355 | $49.7K | $139.97 | 2.16x |
| 87491 | Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | 803 | $27.6K | $34.39 | 2.06x |
| 87563 | Detection of mycoplasma genitalium by dna or rna probe | 803 | $27.6K | $34.39 | 2.06x |
| 87591 | Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | 803 | $27.6K | $34.39 | 2.06x |
| 87661 | Detection test by nucleic acid for trichomonas vaginalis (genital parasite), amplified probe technique | 800 | $27.5K | $34.39 | 2.06x |
| 87486 | Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique | 448 | $15.4K | $34.41 | 2.12x |
| 87541 | Detection test by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique | 448 | $15.4K | $34.41 | 2.12x |
| 87581 | Detection test by nucleic acid for mycoplasma pneumoniae (bacteria), amplified probe technique | 448 | $15.4K | $34.41 | 2.12x |
| 87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | 42 | $5.9K | $139.78 | 2.05x |
This provider submits charges 3.2 times higher than what Medicare actually pays.
A markup ratio of 3.2x means for every $100 Medicare pays, this provider initially charges $320. This is higher than the national average.
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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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