Statistical flag only — not an accusation of fraud
This provider's $216.4M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 500% from 2014 to 2023.
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 72% 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 | $300.62 | $110.42 | 2.72x | $190.20 | $5.4M | 49.1K | 48 |
| 2015 | $381.25 | $103.85 | 3.67x | $277.40 | $5.9M | 56.9K | 61 |
| 2016 | $373.09 | $112.84 | 3.31x | $260.25 | $9.0M | 79.5K | 69 |
| 2017 | $187.65 | $102.63 | 1.83x | $85.02 | $15.4M | 150.0K | 81 |
| 2018 | $207.98 | $101.36 | 2.05x | $106.62 | $19.2M | 189.6K | 100 |
| 2019 | $250.61 | $103.53 | 2.42x | $147.08 | $25.3M | 243.9K | 104 |
| 2020 | $255.79 | $111.03 | 2.30x | $144.76 | $34.1M | 307.3K | 107 |
| 2021 | $241.41 | $110.65 | 2.18x | $130.76 | $38.1M | 344.6K | 90 |
| 2022 | $240.33 | $105.87 | 2.27x | $134.46 | $31.4M | 296.4K | 75 |
| 2023 | $280.07 | $132.10 | 2.12x | $147.97 | $32.6M | 246.4K | 75 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81479 | Molecular pathology procedure | 82.3K | $56.3M | $683.53 | 1.66x |
| 88377 | Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure | 146.2K | $25.7M | $175.88 | 2.14x |
| 88374 | Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure | 184.8K | $19.1M | $103.11 | 3.18x |
| 81450 | Targeted genomic sequence analysis panel of dna or combine dna and rna of 5-50 genes associated with blood and lymphatic system disorders | 21.9K | $15.5M | $710.18 | 4.06x |
| 88185 | Flow cytometry technique for dna or cell analysis, each additional marker | 537.1K | $13.6M | $25.38 | 3.01x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 205.4K | $9.9M | $48.20 | 2.31x |
| 88360 | Microscopic genetic analysis of tumor, manual | 106.4K | $7.2M | $67.68 | 2.01x |
| 81235 | Gene analysis (epidermal growth factor receptor), common variants | 20.1K | $6.1M | $302.21 | 1.85x |
| 88361 | Microscopic genetic analysis of tumor, using computer-assisted technology | 85.5K | $5.8M | $68.40 | 1.98x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 80.8K | $4.7M | $58.44 | 1.94x |
| 88237 | Tissue culture for tumor disorders of bone marrow and blood cells | 29.5K | $4.3M | $145.36 | 1.86x |
| 88189 | Flow cytometry technique for dna or cell analysis, 16 or more markers | 53.1K | $4.0M | $74.77 | 2.30x |
| 81210 | Gene analysis (v-raf murine sarcoma viral oncogene homolog b1) | 23.6K | $3.9M | $165.03 | 1.72x |
| 81270 | Gene analysis (janus kinase 2) variant | 22.9K | $2.3M | $101.42 | 3.05x |
| 81301 | Microsatellite instability analysis | 6.3K | $2.2M | $347.02 | 1.64x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 41.3K | $2.1M | $51.87 | 1.82x |
| 81263 | Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis | 6.0K | $2.0M | $332.32 | 1.51x |
| 88291 | Interpretation and report of genetic testing | 68.8K | $2.0M | $28.59 | 2.03x |
| 81342 | Gene rearrangement analysis detection abnormal clonal population (t cell antigen receptor gamma) | 8.7K | $1.9M | $213.38 | 1.85x |
| 88264 | Chromosome analysis for genetic defects, analyze 20-25 cells | 12.3K | $1.8M | $148.39 | 1.95x |
This provider submits charges 2.3 times higher than what Medicare actually pays.
A markup ratio of 2.3x means for every $100 Medicare pays, this provider initially charges $230. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Genomic Health, Inc. | Redwood City, CA | $887.6M | ✓ Clear |
| Unilab Corporation | West Hills, CA | $868.8M | ⚠️ Flagged |
| Caredx Inc. | Brisbane, CA | $751.0M | ✓ Clear |
| Laboratory Corporation Of America | San Diego, CA | $592.4M | ⚠️ Flagged |
| Millennium Health, Llc | San Diego, CA | $587.9M | ✓ 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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