Statistical flag only — not an accusation of fraud
This provider's $281.2M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 7.75x is significantly above the specialty median of 3.7x.
This provider has been statistically flagged with a risk score of 86/100. 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 | $69.58 | $11.80 | 5.90x | $57.78 | $21.6M | 1.8M | 320 |
| 2015 | $78.04 | $13.82 | 5.65x | $64.22 | $21.7M | 1.6M | 328 |
| 2016 | $77.68 | $13.92 | 5.58x | $63.76 | $23.2M | 1.7M | 330 |
| 2017 | $78.67 | $14.11 | 5.58x | $64.56 | $25.5M | 1.8M | 338 |
| 2018 | $75.25 | $13.84 | 5.44x | $61.41 | $29.6M | 2.1M | 353 |
| 2019 | $89.00 | $12.70 | 7.01x | $76.30 | $30.0M | 2.4M | 354 |
| 2020 | $123.21 | $14.91 | 8.26x | $108.30 | $32.2M | 2.2M | 339 |
| 2021 | $128.10 | $13.80 | 9.28x | $114.30 | $34.7M | 2.5M | 352 |
| 2022 | $139.35 | $13.12 | 10.62x | $126.23 | $32.3M | 2.5M | 363 |
| 2023 | $144.96 | $12.37 | 11.72x | $132.59 | $30.3M | 2.5M | 369 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 1.3M | $24.5M | $18.93 | 6.65x |
| 82306 | Vitamin d-3 level | 693.7K | $23.3M | $33.62 | 8.22x |
| 80053 | Blood test, comprehensive group of blood chemicals | 2.0M | $22.9M | $11.23 | 11.00x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 1.5M | $20.2M | $13.55 | 9.36x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 1.8M | $15.6M | $8.84 | 8.28x |
| 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 | 144.2K | $12.3M | $85.03 | 1.20x |
| 83036 | Hemoglobin a1c level | 1.0M | $11.4M | $10.95 | 7.50x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 498.1K | $8.4M | $16.90 | 8.03x |
| 84153 | Psa (prostate specific antigen) measurement, total | 242.3K | $5.0M | $20.82 | 6.91x |
| 82746 | Folic acid level, serum | 297.1K | $4.9M | $16.61 | 8.04x |
| 86769 | Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody | 115.6K | $4.9M | $41.98 | 3.10x |
| 84439 | Thyroxine (thyroid chemical), free | 472.2K | $4.8M | $10.14 | 12.40x |
| 82728 | Ferritin (blood protein) level | 283.3K | $4.3M | $15.25 | 8.72x |
| 87086 | Bacterial colony count, urine | 458.0K | $4.3M | $9.32 | 7.99x |
| 83970 | Parathormone (parathyroid hormone) level | 79.1K | $3.7M | $46.26 | 6.16x |
| 36415 | Insertion of needle into vein for collection of blood sample | 927.9K | $3.2M | $3.49 | 4.66x |
| 83550 | Iron binding capacity | 272.6K | $2.7M | $9.80 | 9.44x |
| 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 | 84.8K | $2.6M | $30.12 | 4.82x |
| 83540 | Iron level | 344.2K | $2.5M | $7.34 | 7.54x |
| 87077 | Bacterial culture for aerobic isolates | 264.6K | $2.4M | $9.23 | 5.47x |
This provider submits charges 7.75 times higher than what Medicare actually pays.
A markup ratio of 7.75x means for every $100 Medicare pays, this provider initially charges $775. 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 |
| Lenco Diagnostic Laboratories,inc. | Brooklyn, NY | $101.5M | ⚠️ 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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