This provider's $5.5M in total Medicare payments ranks in the 83th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 531% from 2022 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 531% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2022 | $75.30 | $34.87 | 2.16x | $40.43 | $753.6K | 21.6K | 11 |
| 2023 | $69.79 | $34.39 | 2.03x | $35.40 | $4.8M | 138.4K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 94.3K | $3.2M | $34.39 | 2.05x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 34.2K | $1.2M | $34.39 | 2.05x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 7.3K | $250.6K | $34.39 | 2.04x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 6.8K | $233.3K | $34.39 | 2.05x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 6.8K | $233.3K | $34.39 | 2.05x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 4.8K | $166.0K | $34.39 | 2.18x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 2.2K | $75.3K | $34.39 | 2.07x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 202 | $28.2K | $139.78 | 1.43x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 236 | $22.2K | $93.88 | 1.33x |
| 87634 | Detection test by nucleic acid for respiratory syncytial virus, amplified probe technique | 237 | $16.3K | $68.80 | 1.82x |
| 87486 | Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique | 375 | $12.9K | $34.39 | 1.79x |
| 87541 | Detection test by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique | 375 | $12.9K | $34.39 | 1.79x |
| 87581 | Detection test by nucleic acid for mycoplasma pneumoniae (bacteria), amplified probe technique | 375 | $12.9K | $34.39 | 1.79x |
| 87506 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets | 32 | $8.2K | $257.73 | 2.13x |
| 87498 | Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique | 232 | $8.0K | $34.39 | 2.18x |
| 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 | 82 | $6.0K | $73.50 | 2.04x |
| 81003 | Automated urinalysis test | 1.3K | $2.9K | $2.20 | 2.27x |
| 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 | 82 | $2.0K | $24.50 | 1.43x |
| 87661 | Detection test by nucleic acid for trichomonas vaginalis (genital parasite), amplified probe technique | 33 | $1.1K | $34.39 | 2.03x |
| 87491 | Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | 24 | $825.36 | $34.39 | 2.01x |
This provider submits charges 2.05 times higher than what Medicare actually pays.
A markup ratio of 2.05x means for every $100 Medicare pays, this provider initially charges $205. 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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