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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. Altheadx, Inc.
🔬
Organization

Altheadx, Inc.

NPI: 1528490240
San Diego, CA
7 years of data
Clinical Laboratory
$24.7M
Total Payments
90.9K
Beneficiaries
92.7K
Services
1.58x
Markup Ratio

Peer Comparison

96th
percentile in specialty
This provider$24.7M
Specialty median$1.9M

📋 Key Findings

1Billed $24.7M over 7 years
21.58x markup ratio
396th percentile in Clinical Laboratory by payments
4Payments surged 755% in 2021
51 procedure with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $24.7M in total Medicare payments ranks in the 96th 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 755% in 2021

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$316.15$192.911.64x$123.24$10.5M41.1K40.0K
2015$305.83$183.861.66x$121.97$7.8M33.0K32.4K
2016$295.00$186.591.58x$108.41$3.0M11.4K11.4K
2017$413.33$263.731.57x$149.60$2.5M6.5K6.5K
2018$545.00$363.711.50x$181.29$28.2K7171
2021$2.8K$1.0K2.75x$1.8K$241.4K176176
2022$2.0K$761.042.67x$1.3K$622.4K452451

Top Procedures (8)

81226Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants
$12.8M
29.0K services$442.40/svc1.58x markup
81225Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants
$7.6M
26.7K services$285.76/svc1.37x markup
81402Molecular pathology procedure level 3
$1.2M
3.2K services$382.12/svc1.05x markup
81291Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants
$1.1M
18.1K services$58.27/svc2.57x markup
81479Molecular pathology procedure⚠ 3.0x markup
$824.7K
530 services$1.6K/svc3.02x markup
81241Gene analysis (coagulation factor V) Leiden variant
$609.0K
7.5K services$81.56/svc1.35x markup
81240Gene analysis (prothrombin, coagulation factor II) A variant
$491.5K
7.5K services$65.68/svc1.90x markup
81227Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common variants
$45.3K
266 services$170.43/svc2.11x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
81226Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants29.0K$12.8M$442.401.58x
81225Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants26.7K$7.6M$285.761.37x
81402Molecular pathology procedure level 33.2K$1.2M$382.121.05x
81291Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants18.1K$1.1M$58.272.57x
81479Molecular pathology procedure530$824.7K$1.6K3.02x
81241Gene analysis (coagulation factor V) Leiden variant7.5K$609.0K$81.561.35x
81240Gene analysis (prothrombin, coagulation factor II) A variant7.5K$491.5K$65.681.90x
81227Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common variants266$45.3K$170.432.11x

Markup Analysis

Charge-to-Payment Ratio

1.58x

This provider submits charges 1.58 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.58x means for every $100 Medicare pays, this provider initially charges $158. This is lower than the national average.

Location

San Diego, 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.

Altheadx, Inc. (you)
$24.7M
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