This provider's $24.8M in total Medicare payments ranks in the 96th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 5331% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1402% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $2.90 | $1.45 | 2.00x | $1.45 | $146.2K | 101.0K | 18 |
| 2017 | $2.60 | $1.45 | 1.79x | $1.15 | $2.2M | 1.5M | 64 |
| 2018 | $2.44 | $1.40 | 1.74x | $1.04 | $3.3M | 2.3M | 67 |
| 2019 | $4.03 | $1.78 | 2.26x | $2.25 | $2.9M | 1.6M | 70 |
| 2020 | $5.83 | $2.22 | 2.63x | $3.61 | $2.1M | 943.6K | 75 |
| 2021 | $6.51 | $2.43 | 2.68x | $4.08 | $2.6M | 1.1M | 71 |
| 2022 | $7.42 | $3.09 | 2.40x | $4.33 | $3.6M | 1.2M | 79 |
| 2023 | $9.58 | $5.45 | 1.76x | $4.13 | $7.9M | 1.5M | 80 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 8.9M | $8.9M | $1.00 | 1.02x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 103.3K | $3.6M | $34.39 | 1.16x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 183.9K | $1.5M | $8.18 | 4.03x |
| 36415 | Insertion of needle into vein for collection of blood sample | 354.9K | $1.4M | $4.01 | 2.49x |
| 80053 | Blood test, comprehensive group of blood chemicals | 117.4K | $1.3M | $10.96 | 4.10x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 49.2K | $866.6K | $17.60 | 1.66x |
| 81007 | Urinalysis for bacteria | 25.8K | $765.1K | $29.64 | 2.02x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 42.9K | $590.4K | $13.75 | 4.00x |
| 82306 | Vitamin d-3 level | 15.9K | $483.8K | $30.45 | 4.01x |
| 83036 | Hemoglobin a1c level | 46.8K | $475.7K | $10.17 | 3.44x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 50.1K | $450.4K | $9.00 | 4.00x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 10.3K | $355.9K | $34.39 | 1.16x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 10.3K | $355.4K | $34.39 | 1.16x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 10.3K | $355.3K | $34.39 | 1.16x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 9.0K | $310.9K | $34.39 | 1.16x |
| 80164 | Valproic acid level, total | 21.4K | $305.8K | $14.30 | 3.99x |
| 80069 | Kidney function blood test panel | 30.0K | $275.8K | $9.20 | 4.02x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 6.3K | $248.9K | $39.21 | 3.72x |
| 84134 | Prealbumin (protein) level | 16.1K | $233.4K | $14.54 | 1.65x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 11.0K | $174.3K | $15.83 | 4.04x |
This provider submits charges 2.09 times higher than what Medicare actually pays.
A markup ratio of 2.09x means for every $100 Medicare pays, this provider initially charges $209. This is higher than the national average.
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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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