This provider's $86.9M 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.
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 | $40.35 | $13.12 | 3.08x | $27.23 | $7.0M | 535.9K | 235 |
| 2015 | $41.25 | $13.48 | 3.06x | $27.77 | $7.5M | 558.8K | 228 |
| 2016 | $41.83 | $13.50 | 3.10x | $28.33 | $8.0M | 595.3K | 232 |
| 2017 | $42.30 | $13.68 | 3.09x | $28.62 | $8.6M | 627.0K | 247 |
| 2018 | $43.85 | $13.24 | 3.31x | $30.61 | $8.5M | 642.8K | 225 |
| 2019 | $43.97 | $12.02 | 3.66x | $31.95 | $8.2M | 681.8K | 227 |
| 2020 | $53.11 | $12.44 | 4.27x | $40.67 | $8.1M | 654.0K | 225 |
| 2021 | $54.50 | $13.16 | 4.14x | $41.34 | $10.4M | 787.7K | 218 |
| 2022 | $54.54 | $13.19 | 4.13x | $41.35 | $10.7M | 810.6K | 225 |
| 2023 | $53.45 | $12.36 | 4.32x | $41.09 | $9.8M | 795.9K | 231 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 600.8K | $6.8M | $11.32 | 4.22x |
| 82306 | Vitamin d-3 level | 188.4K | $6.4M | $34.06 | 3.52x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 313.7K | $6.0M | $19.17 | 3.47x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 565.7K | $5.0M | $8.88 | 3.43x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 321.0K | $4.3M | $13.26 | 4.12x |
| 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 | 43.4K | $3.4M | $77.99 | 1.75x |
| 36415 | Insertion of needle into vein for collection of blood sample | 847.0K | $3.1M | $3.61 | 4.26x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 58.1K | $3.0M | $52.01 | 4.52x |
| 83036 | Hemoglobin a1c level | 217.1K | $2.4M | $11.04 | 4.18x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 108.5K | $1.8M | $17.01 | 3.50x |
| 84153 | Psa (prostate specific antigen) measurement, total | 82.4K | $1.7M | $20.60 | 3.68x |
| 83970 | Parathormone (parathyroid hormone) level | 35.7K | $1.7M | $46.75 | 3.62x |
| 84439 | Thyroxine (thyroid chemical), free | 132.4K | $1.4M | $10.41 | 4.32x |
| 87086 | Bacterial colony count, urine | 147.8K | $1.3M | $9.05 | 3.70x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 31.9K | $1.3M | $41.65 | 3.34x |
| 84403 | Testosterone (hormone) level, total | 45.1K | $1.3M | $29.29 | 3.11x |
| 82728 | Ferritin (blood protein) level | 60.7K | $944.3K | $15.54 | 3.60x |
| 87077 | Bacterial culture for aerobic isolates | 91.5K | $833.3K | $9.11 | 3.66x |
| 81001 | Manual urinalysis test with examination using microscope, automated | 231.1K | $832.8K | $3.60 | 5.35x |
| U0005 | 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, cdc or non-cdc, making use of high throughput technologies, completed within | 32.5K | $807.8K | $24.82 | 1.40x |
This provider submits charges 3.67 times higher than what Medicare actually pays.
A markup ratio of 3.67x means for every $100 Medicare pays, this provider initially charges $367. 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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