Statistical flag only — not an accusation of fraud
This provider's $34.2M in total Medicare payments ranks in the 97th 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 194787% 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 | $45.84 | $11.86 | 3.87x | $33.98 | $4.7M | 399.6K | 200 |
| 2015 | $45.35 | $11.59 | 3.91x | $33.76 | $4.9M | 423.8K | 201 |
| 2016 | $46.23 | $12.02 | 3.85x | $34.21 | $5.6M | 462.8K | 207 |
| 2017 | $46.33 | $12.06 | 3.84x | $34.27 | $5.7M | 475.6K | 210 |
| 2018 | $47.07 | $12.10 | 3.89x | $34.97 | $5.8M | 482.8K | 216 |
| 2019 | $48.46 | $11.32 | 4.28x | $37.14 | $2.4M | 211.6K | 173 |
| 2020 | $32.25 | $4.26 | 7.57x | $27.99 | $673.76 | 158 | 1 |
| 2021 | $32.42 | $4.27 | 7.59x | $28.15 | $965.02 | 226 | 1 |
| 2022 | $50.36 | $10.54 | 4.78x | $39.82 | $1.9M | 178.4K | 153 |
| 2023 | $52.77 | $11.44 | 4.61x | $41.33 | $3.1M | 272.2K | 166 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 156.2K | $3.2M | $20.73 | 2.93x |
| 80053 | Blood test, comprehensive group of blood chemicals | 280.2K | $3.2M | $11.44 | 4.56x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 221.5K | $3.1M | $14.19 | 5.05x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 274.9K | $2.7M | $9.70 | 2.91x |
| 82306 | Vitamin d-3 level | 68.7K | $2.4M | $34.49 | 3.19x |
| 83036 | Hemoglobin a1c level | 135.5K | $1.6M | $12.02 | 4.87x |
| 36415 | Insertion of needle into vein for collection of blood sample | 463.1K | $1.6M | $3.41 | 2.13x |
| 84153 | Psa (prostate specific antigen) measurement, total | 34.0K | $770.0K | $22.63 | 3.06x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 37.0K | $684.5K | $18.48 | 4.16x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 77.3K | $675.6K | $8.74 | 4.26x |
| 83970 | Parathormone (parathyroid hormone) level | 11.3K | $570.5K | $50.31 | 4.98x |
| 84439 | Thyroxine (thyroid chemical), free | 51.9K | $569.4K | $10.98 | 6.81x |
| 87086 | Bacterial colony count, urine | 49.5K | $498.4K | $10.08 | 5.09x |
| 82728 | Ferritin (blood protein) level | 26.1K | $442.2K | $16.91 | 4.26x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 19.3K | $437.7K | $22.66 | 3.06x |
| 82746 | Folic acid level, serum | 19.9K | $359.5K | $18.11 | 4.25x |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision | 11.7K | $355.1K | $30.28 | 2.48x |
| 84481 | Thyroid hormone, t3 measurement, free | 15.4K | $313.2K | $20.36 | 3.66x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 29.5K | $297.8K | $10.08 | 4.93x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 7.3K | $271.4K | $37.27 | 5.52x |
This provider submits charges 4.02 times higher than what Medicare actually pays.
A markup ratio of 4.02x means for every $100 Medicare pays, this provider initially charges $402. 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 OH for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Laboratory Corporation Of America Holdings | Dublin, OH | $659.2M | ⚠️ Flagged |
| Assurex Health, Inc. | Mason, OH | $253.0M | ✓ Clear |
| American Health Mw, Llc | Cincinnati, OH | $178.9M | ✓ Clear |
| Cleveland Heartlab Inc | Cleveland, OH | $91.8M | ⚠️ Flagged |
| Compunet Clinical Laboratories Llc | Moraine, OH | $77.5M | ✓ 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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