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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Pacific Point Laboratories, Inc.
🔬
Organization

Pacific Point Laboratories, Inc.

NPI: 1457341851
San Luis Obispo, CA
10 years of data
Clinical Laboratory
$113.6M
Total Payments
2.8K
Beneficiaries
8.8M
Services
2.72x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$113.6M
Specialty median$1.9M
Rank #67 of 232 in specialty

📋 Key Findings

1Billed $113.6M over 10 years
22.72x markup ratio (above median)
399th percentile in Clinical Laboratory by payments
4Payments surged 72% in 2017
54 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $113.6M in total Medicare payments ranks in the 99th 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.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 72% in 2017

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$36.18$13.352.71x$22.83$10.3M774.6K272
2015$36.63$13.352.74x$23.28$10.2M766.8K252
2016$33.93$13.062.60x$20.87$9.6M733.4K270
2017$36.19$13.572.67x$22.62$16.5M1.2M310
2018$34.46$12.992.65x$21.47$15.1M1.2M327
2019$34.08$11.802.89x$22.28$12.3M1.0M302
2020$35.94$14.062.56x$21.88$12.4M880.3K285
2021$34.73$12.842.70x$21.89$10.4M807.6K277
2022$34.33$11.852.90x$22.48$8.3M698.8K263
2023$34.03$11.742.90x$22.29$8.5M722.5K272

Top Procedures (20)

80053Blood test, comprehensive group of blood chemicals⚠ 3.0x markup
$8.9M
775.8K services$11.44/svc3.02x markup
82306Vitamin d-3 level
$8.0M
231.5K services$34.66/svc2.52x markup
84443Blood test, thyroid stimulating hormone (tsh)
$8.0M
407.6K services$19.56/svc2.55x markup
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
$7.1M
776.5K services$9.10/svc2.56x markup
80061Blood test, lipids (cholesterol and triglycerides)⚠ 3.2x markup
$6.9M
499.4K services$13.85/svc3.23x markup
U0003Infectious 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
$4.7M
53.5K services$88.74/svc1.13x markup
36415Insertion of needle into vein for collection of blood sample⚠ 3.1x markup
$3.8M
1.1M services$3.36/svc3.13x markup
88305Pathology examination of tissue using a microscope, intermediate complexity⚠ 5.8x markup
$3.7M
135.5K services$27.52/svc5.75x markup
83036Hemoglobin a1c level
$3.5M
315.5K services$11.20/svc2.60x markup
82607Cyanocobalamin (vitamin b-12) level
$2.2M
127.8K services$17.55/svc2.61x markup
84153Psa (prostate specific antigen) measurement, total
$2.2M
104.7K services$21.08/svc2.59x markup
83970Parathormone (parathyroid hormone) level
$2.0M
43.1K services$47.49/svc2.57x markup
84439Thyroxine (thyroid chemical), free
$1.7M
166.6K services$10.42/svc2.47x markup
87086Bacterial colony count, urine
$1.7M
179.9K services$9.45/svc2.58x markup
80048Blood test, basic group of blood chemicals (calcium, total)
$1.6M
168.2K services$9.33/svc2.72x markup
84403Testosterone (hormone) level, total
$1.5M
50.5K services$29.19/svc2.59x markup
86235Measurement of antibody for assessment of autoimmune disorder, any method
$1.3M
65.6K services$19.51/svc2.44x markup
83880Natriuretic peptide (heart and blood vessel protein) level
$1.2M
30.3K services$40.95/svc2.32x markup
87186Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution
$1.2M
118.3K services$10.17/svc2.59x markup
84481Thyroid hormone, t3 measurement, free
$1.2M
58.9K services$19.75/svc2.47x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
80053Blood test, comprehensive group of blood chemicals775.8K$8.9M$11.443.02x
82306Vitamin d-3 level231.5K$8.0M$34.662.52x
84443Blood test, thyroid stimulating hormone (tsh)407.6K$8.0M$19.562.55x
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count776.5K$7.1M$9.102.56x
80061Blood test, lipids (cholesterol and triglycerides)499.4K$6.9M$13.853.23x
U0003Infectious 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-r53.5K$4.7M$88.741.13x
36415Insertion of needle into vein for collection of blood sample1.1M$3.8M$3.363.13x
88305Pathology examination of tissue using a microscope, intermediate complexity135.5K$3.7M$27.525.75x
83036Hemoglobin a1c level315.5K$3.5M$11.202.60x
82607Cyanocobalamin (vitamin b-12) level127.8K$2.2M$17.552.61x
84153Psa (prostate specific antigen) measurement, total104.7K$2.2M$21.082.59x
83970Parathormone (parathyroid hormone) level43.1K$2.0M$47.492.57x
84439Thyroxine (thyroid chemical), free166.6K$1.7M$10.422.47x
87086Bacterial colony count, urine179.9K$1.7M$9.452.58x
80048Blood test, basic group of blood chemicals (calcium, total)168.2K$1.6M$9.332.72x
84403Testosterone (hormone) level, total50.5K$1.5M$29.192.59x
86235Measurement of antibody for assessment of autoimmune disorder, any method65.6K$1.3M$19.512.44x
83880Natriuretic peptide (heart and blood vessel protein) level30.3K$1.2M$40.952.32x
87186Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution118.3K$1.2M$10.172.59x
84481Thyroid hormone, t3 measurement, free58.9K$1.2M$19.752.47x

Markup Analysis

Charge-to-Payment Ratio

2.72x

This provider submits charges 2.72 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.72x means for every $100 Medicare pays, this provider initially charges $272. This is higher than the national average.

Location

San Luis Obispo, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Clinical Laboratory providers in CA for peer comparison.

Pacific Point Laboratories, Inc. (you)
$113.6M
Genomic Health, Inc.
$887.6M
Unilab Corporation⚠️
$868.8M
Caredx Inc.
$751.0M
Laboratory Corporation Of America⚠️
$592.4M
Millennium Health, Llc
$587.9M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Genomic Health, Inc.Redwood City, CA$887.6M✓ Clear
Unilab CorporationWest Hills, CA$868.8M⚠️ Flagged
Caredx Inc.Brisbane, CA$751.0M✓ Clear
Laboratory Corporation Of AmericaSan Diego, CA$592.4M⚠️ Flagged
Millennium Health, LlcSan Diego, CA$587.9M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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.

Believe this data is inaccurate? Dispute this data