This provider's $20.0M in total Medicare payments ranks in the 95th percentile of Clinical Laboratory providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $25.24 | $20.09 | 1.26x | $5.15 | $4.4M | 346.0K | 218.2K |
| 2015 | $83.24 | $21.18 | 3.93x | $62.06 | $3.2M | 251.4K | 172.8K |
| 2016 | $86.90 | $19.96 | 4.35x | $66.94 | $3.2M | 245.9K | 175.0K |
| 2017 | $52.17 | $14.00 | 3.73x | $38.17 | $2.7M | 218.0K | 145.7K |
| 2018 | $29.44 | $13.50 | 2.18x | $15.94 | $2.5M | 216.0K | 149.2K |
| 2019 | $34.32 | $11.18 | 3.07x | $23.14 | $2.3M | 210.2K | 145.5K |
| 2020 | $52.47 | $9.83 | 5.34x | $42.64 | $1.1M | 137.8K | 92.3K |
| 2021 | $41.78 | $8.50 | 4.92x | $33.28 | $534.0K | 68.7K | 54.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 82306 | Vitamin D-3 level | 59.4K | $2.2M | $37.87 | 3.56x |
| 80053 | Blood test, comprehensive group of blood chemicals | 171.7K | $2.0M | $11.54 | 2.92x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 80.7K | $1.7M | $21.40 | 3.22x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 118.0K | $1.7M | $14.10 | 3.27x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 164.7K | $1.6M | $9.53 | 2.54x |
| 83036 | Hemoglobin A1C level | 83.1K | $978.7K | $11.78 | 6.22x |
| 36415 | Insertion of needle into vein for collection of blood sample | 244.8K | $720.7K | $2.94 | 2.24x |
| 84153 | PSA (prostate specific antigen) measurement | 26.2K | $607.0K | $23.18 | 2.85x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 28.0K | $539.7K | $19.28 | 3.07x |
| 82746 | Folic acid level | 18.9K | $352.4K | $18.69 | 3.27x |
| 84439 | Thyroxine (thyroid chemical) measurement | 28.5K | $326.4K | $11.45 | 4.04x |
| 87086 | Bacterial colony count, urine | 30.7K | $309.4K | $10.07 | 2.69x |
| 80048 | Blood test, basic group of blood chemicals | 30.7K | $304.3K | $9.91 | 1.93x |
| 84481 | Thyroid hormone, T3 measurement | 12.4K | $266.7K | $21.51 | 5.16x |
| 84403 | Testosterone (hormone) level | 8.1K | $263.0K | $32.28 | 2.73x |
| 81001 | Manual urinalysis test with examination using microscope | 63.6K | $245.8K | $3.86 | 4.85x |
| 82728 | Ferritin (blood protein) level | 12.3K | $212.6K | $17.25 | 3.14x |
| 82274 | Stool analysis for blood | 10.4K | $210.0K | $20.27 | 2.53x |
| 87077 | Bacterial culture for aerobic isolates | 19.7K | $198.3K | $10.08 | 1.44x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 17.5K | $189.8K | $10.82 | 1.65x |
This provider submits charges 3.23 times higher than what Medicare actually pays.
A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. 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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