Statistical flag only — not an accusation of fraud
This provider's $97.9M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 6.1x is significantly above the specialty median of 3.7x.
Medicare payments to this provider grew 66% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 77/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 61% in 2017
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 | $57.78 | $11.16 | 5.18x | $46.62 | $6.4M | 571.4K | 184 |
| 2015 | $63.18 | $11.57 | 5.46x | $51.61 | $6.4M | 551.5K | 183 |
| 2016 | $65.53 | $12.00 | 5.46x | $53.53 | $5.9M | 494.0K | 181 |
| 2017 | $70.28 | $12.22 | 5.75x | $58.06 | $9.5M | 781.4K | 236 |
| 2018 | $69.46 | $12.08 | 5.75x | $57.38 | $12.0M | 989.6K | 267 |
| 2019 | $71.96 | $10.95 | 6.57x | $61.01 | $11.6M | 1.1M | 262 |
| 2020 | $74.76 | $11.88 | 6.29x | $62.88 | $11.4M | 960.9K | 266 |
| 2021 | $74.37 | $12.18 | 6.11x | $62.19 | $12.5M | 1.0M | 271 |
| 2022 | $75.42 | $11.85 | 6.36x | $63.57 | $11.5M | 974.3K | 266 |
| 2023 | $80.77 | $11.46 | 7.05x | $69.31 | $10.6M | 925.5K | 272 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 967.9K | $10.0M | $10.35 | 6.42x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 488.0K | $9.3M | $19.13 | 5.73x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 593.9K | $8.5M | $14.36 | 8.57x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 751.8K | $6.6M | $8.81 | 4.59x |
| 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 | 51.7K | $4.2M | $82.14 | 1.22x |
| 83036 | Hemoglobin a1c level | 355.8K | $3.9M | $11.02 | 6.30x |
| 36415 | Insertion of needle into vein for collection of blood sample | 1.1M | $3.8M | $3.54 | 6.09x |
| 82306 | Vitamin d-3 level | 100.4K | $3.3M | $33.20 | 6.58x |
| 84153 | Psa (prostate specific antigen) measurement, total | 98.1K | $2.1M | $20.92 | 6.21x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 112.7K | $1.9M | $17.06 | 5.34x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 214.5K | $1.8M | $8.59 | 6.54x |
| 87086 | Bacterial colony count, urine | 172.0K | $1.6M | $9.13 | 6.16x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 36.2K | $1.5M | $41.07 | 4.38x |
| 84439 | Thyroxine (thyroid chemical), free | 140.3K | $1.4M | $10.15 | 11.18x |
| 82728 | Ferritin (blood protein) level | 84.7K | $1.3M | $15.09 | 6.06x |
| 87088 | Bacterial urine culture | 145.8K | $1.2M | $8.48 | 3.67x |
| 83970 | Parathormone (parathyroid hormone) level | 26.7K | $1.1M | $41.22 | 5.39x |
| 82746 | Folic acid level, serum | 64.1K | $1.1M | $16.47 | 5.12x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 105.4K | $1.0M | $9.80 | 6.89x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 43.3K | $927.6K | $21.41 | 6.36x |
This provider submits charges 6.1 times higher than what Medicare actually pays.
A markup ratio of 6.1x means for every $100 Medicare pays, this provider initially charges $610. 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 WA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Laboratory Corporation Of America | Seattle, WA | $203.1M | ⚠️ Flagged |
| Carenexa, Llc | Vancouver, WA | $70.5M | ✓ Clear |
| Adaptive Biotechnologies Corporation | Seattle, WA | $54.5M | ✓ Clear |
| Regional Toxicology Services, Llc | Tacoma, WA | $37.2M | ✓ 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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