This provider's $19.5M in total Medicare payments ranks in the 95th 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 | $83.29 | $20.62 | 4.04x | $62.67 | $2.2M | 177.1K | 125.6K |
| 2015 | $85.92 | $20.97 | 4.10x | $64.95 | $2.0M | 165.1K | 112.3K |
| 2016 | $90.45 | $22.39 | 4.04x | $68.06 | $2.1M | 167.3K | 115.9K |
| 2017 | $91.90 | $23.38 | 3.93x | $68.52 | $2.1M | 165.2K | 111.4K |
| 2018 | $89.05 | $20.38 | 4.37x | $68.67 | $2.1M | 168.4K | 110.7K |
| 2019 | $84.70 | $17.21 | 4.92x | $67.49 | $2.0M | 175.3K | 111.2K |
| 2020 | $80.34 | $15.94 | 5.04x | $64.40 | $2.0M | 138.9K | 87.6K |
| 2021 | $80.04 | $16.78 | 4.77x | $63.26 | $2.0M | 140.6K | 88.8K |
| 2022 | $77.18 | $15.01 | 5.14x | $62.17 | $1.8M | 131.7K | 77.1K |
| 2023 | $79.57 | $16.49 | 4.83x | $63.08 | $1.2M | 108.2K | 73.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 162.2K | $1.8M | $10.98 | 5.28x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 124.4K | $1.6M | $13.22 | 5.21x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 19.3K | $1.6M | $83.30 | 3.32x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 80.3K | $1.6M | $20.00 | 4.65x |
| 82306 | Vitamin D-3 level | 43.9K | $1.5M | $35.06 | 3.54x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 162.7K | $1.5M | $9.20 | 4.67x |
| 83036 | Hemoglobin A1C level | 93.3K | $1.1M | $11.41 | 4.73x |
| 84153 | PSA (prostate specific antigen) measurement | 24.4K | $538.1K | $22.02 | 4.63x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge. | 25.4K | $500.7K | $19.75 | 1.77x |
| 36415 | Insertion of needle into vein for collection of blood sample | 110.6K | $377.7K | $3.42 | 6.86x |
| 81001 | Manual urinalysis test with examination using microscope | 93.5K | $351.6K | $3.76 | 4.79x |
| 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 | 12.6K | $313.0K | $24.91 | 1.61x |
| 84439 | Thyroxine (thyroid chemical) measurement | 22.5K | $241.7K | $10.73 | 4.66x |
| 82043 | Urine microalbumin (protein) level | 34.2K | $230.2K | $6.73 | 4.75x |
| 84480 | Thyroid hormone, T3 measurement | 13.3K | $226.6K | $17.06 | 4.57x |
| 87086 | Bacterial colony count, urine | 23.5K | $226.5K | $9.62 | 3.95x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 12.1K | $211.4K | $17.41 | 4.77x |
| 87517 | Detection test for Hepatitis B virus | 4.1K | $205.1K | $50.34 | 4.63x |
| 82378 | Carcinoembryonic antigen (CEA) protein level | 9.1K | $201.7K | $22.13 | 4.74x |
| 82105 | Alpha-fetoprotein (AFP) level, serum | 9.6K | $189.5K | $19.76 | 3.04x |
This provider submits charges 4.5 times higher than what Medicare actually pays.
A markup ratio of 4.5x means for every $100 Medicare pays, this provider initially charges $450. 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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