This provider's $6.9M in total Medicare payments ranks in the 99th percentile of Mass Immunizer Roster Biller providers nationally.
Medicare payments to this provider grew 621% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1482% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $637.13 | $155.45 | 4.10x | $481.68 | $56.9K | 310 | 293 |
| 2018 | $500.00 | $165.07 | 3.03x | $334.93 | $900.7K | 5.5K | 3.6K |
| 2019 | $309.89 | $184.23 | 1.68x | $125.66 | $603.8K | 4.7K | 3.2K |
| 2020 | $284.84 | $240.99 | 1.18x | $43.85 | $919.0K | 5.3K | 4.1K |
| 2021 | $239.45 | $195.78 | 1.22x | $43.67 | $2.6M | 16.2K | 10.7K |
| 2022 | $285.08 | $168.32 | 1.69x | $116.76 | $1.4M | 23.8K | 16.5K |
| 2023 | $106.87 | $69.74 | 1.53x | $37.13 | $410.7K | 6.3K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (an | 5.2K | $1.3M | $242.53 | 2.83x |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 7.4K | $837.9K | $113.35 | 1.45x |
| 81493 | Test for detecting genes associated with heart vessels diseases | 751 | $788.3K | $1.0K | 1.91x |
| 81408 | Molecular pathology procedure level 9 | 387 | $770.0K | $2.0K | 1.18x |
| 80307 | Testing for presence of drug | 11.6K | $741.4K | $63.73 | 2.03x |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 884 | $173.3K | $196.01 | 2.29x |
| 81430 | Test for detecting genes causing hearing loss | 97 | $157.6K | $1.6K | 1.17x |
| 81405 | Molecular pathology procedure level 6 | 479 | $143.6K | $299.85 | 1.23x |
| 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 | 1.8K | $143.3K | $79.37 | 1.86x |
| 81404 | Molecular pathology procedure level 5 | 472 | $129.2K | $273.65 | 1.22x |
| 87798 | Detection test for organism | 3.1K | $107.2K | $34.63 | 1.46x |
| 81439 | Test for detecting genes associated with inherited disease of heart muscle | 181 | $104.3K | $576.27 | 1.22x |
| G0481 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (an | 653 | $100.7K | $154.14 | 2.33x |
| 81406 | Molecular pathology procedure level 7 | 355 | $99.8K | $281.07 | 1.21x |
| 87582 | Detection test for Mycoplasma pneumoniae (bacteria) | 298 | $89.7K | $301.08 | 1.15x |
| 87641 | Detection test for staphylococcus aureus, methicillin resistant (mrsa bacteria) | 2.6K | $89.2K | $34.65 | 1.52x |
| 87640 | Detection test for Staphylococcus aureus (bacteria) | 2.5K | $87.0K | $34.60 | 1.55x |
| 87500 | Detection test for Vancomycin resistance strep (VRE) | 2.5K | $86.8K | $34.68 | 1.53x |
| 87653 | Detection test for Strep (Streptococcus, group B) | 2.5K | $85.7K | $34.69 | 1.50x |
| 87481 | Detection test for candida species (yeast) | 2.3K | $80.9K | $34.62 | 1.53x |
This provider submits charges 1.81 times higher than what Medicare actually pays.
A markup ratio of 1.81x means for every $100 Medicare pays, this provider initially charges $181. This is lower 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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