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.
Notable: Payments increased 755% in 2021
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 | $316.15 | $192.91 | 1.64x | $123.24 | $10.5M | 41.1K | 40.0K |
| 2015 | $305.83 | $183.86 | 1.66x | $121.97 | $7.8M | 33.0K | 32.4K |
| 2016 | $295.00 | $186.59 | 1.58x | $108.41 | $3.0M | 11.4K | 11.4K |
| 2017 | $413.33 | $263.73 | 1.57x | $149.60 | $2.5M | 6.5K | 6.5K |
| 2018 | $545.00 | $363.71 | 1.50x | $181.29 | $28.2K | 71 | 71 |
| 2021 | $2.8K | $1.0K | 2.75x | $1.8K | $241.4K | 176 | 176 |
| 2022 | $2.0K | $761.04 | 2.67x | $1.3K | $622.4K | 452 | 451 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81226 | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants | 29.0K | $12.8M | $442.40 | 1.58x |
| 81225 | Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants | 26.7K | $7.6M | $285.76 | 1.37x |
| 81402 | Molecular pathology procedure level 3 | 3.2K | $1.2M | $382.12 | 1.05x |
| 81291 | Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants | 18.1K | $1.1M | $58.27 | 2.57x |
| 81479 | Molecular pathology procedure | 530 | $824.7K | $1.6K | 3.02x |
| 81241 | Gene analysis (coagulation factor V) Leiden variant | 7.5K | $609.0K | $81.56 | 1.35x |
| 81240 | Gene analysis (prothrombin, coagulation factor II) A variant | 7.5K | $491.5K | $65.68 | 1.90x |
| 81227 | Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common variants | 266 | $45.3K | $170.43 | 2.11x |
This provider submits charges 1.58 times higher than what Medicare actually pays.
A markup ratio of 1.58x means for every $100 Medicare pays, this provider initially charges $158. This is lower 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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