Statistical flag only — not an accusation of fraud
This provider's $63.9M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 2963% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 82/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 572% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $253.36 | $14.58 | 17.38x | $238.78 | $923.4K | 63.3K | 70 |
| 2015 | $261.67 | $14.67 | 17.84x | $247.00 | $1.3M | 86.7K | 72 |
| 2016 | $257.59 | $14.07 | 18.31x | $243.52 | $1.2M | 82.2K | 74 |
| 2017 | $359.92 | $17.56 | 20.50x | $342.36 | $1.5M | 83.1K | 71 |
| 2018 | $323.85 | $22.02 | 14.71x | $301.83 | $1.5M | 67.4K | 78 |
| 2019 | $565.88 | $126.24 | 4.48x | $439.64 | $8.7M | 68.8K | 76 |
| 2020 | $365.23 | $78.53 | 4.65x | $286.70 | $11.0M | 139.9K | 89 |
| 2021 | $327.02 | $50.00 | 6.54x | $277.02 | $5.4M | 108.4K | 86 |
| 2022 | $117.22 | $25.11 | 4.67x | $92.11 | $4.2M | 167.7K | 102 |
| 2023 | $16.16 | $12.00 | 1.35x | $4.16 | $28.3M | 2.4M | 87 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 2.4M | $28.3M | $11.76 | 1.17x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 6.6K | $12.5M | $1.9K | 1.71x |
| 81212 | Gene analysis (breast cancer 1 and 2) for 185delag, 5385insc, 6174delt variants | 6.6K | $2.8M | $433.11 | 2.52x |
| 87633 | Detection test for multiple types of respiratory virus | 6.3K | $2.6M | $415.77 | 1.92x |
| 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 | 22.6K | $1.8M | $80.38 | 7.77x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 9.2K | $1.3M | $142.39 | 5.20x |
| G0483 | 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 | 5.1K | $1.2M | $244.48 | 23.05x |
| 82306 | Vitamin d-3 level | 22.8K | $810.2K | $35.59 | 17.04x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 29.9K | $597.7K | $20.01 | 17.10x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 16.3K | $571.8K | $35.02 | 1.93x |
| 87581 | Detection test by nucleic acid for mycoplasma pneumoniae (bacteria), amplified probe technique | 16.2K | $568.1K | $35.02 | 1.92x |
| 87486 | Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique | 16.2K | $567.9K | $35.02 | 2.21x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 186 | $436.7K | $2.3K | 2.04x |
| 84481 | Thyroid hormone, t3 measurement, free | 21.8K | $435.4K | $19.95 | 17.06x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 23.3K | $411.9K | $17.71 | 16.90x |
| 80053 | Blood test, comprehensive group of blood chemicals | 37.1K | $404.7K | $10.90 | 27.90x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 16.4K | $382.5K | $23.31 | 2.01x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 30.0K | $363.9K | $12.13 | 22.44x |
| 82746 | Folic acid level, serum | 20.0K | $349.3K | $17.49 | 17.09x |
| 81226 | Gene analysis (cytochrome p450, family 2, subfamily d, polypeptide 6) common variants | 770 | $340.4K | $442.10 | 2.01x |
This provider submits charges 4.62 times higher than what Medicare actually pays.
A markup ratio of 4.62x means for every $100 Medicare pays, this provider initially charges $462. 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 NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Northwell Health Laboratories | New Hyde Park, NY | $299.4M | ⚠️ Flagged |
| Sunrise Medical Laboratories, Inc. | Hicksville, NY | $281.2M | ⚠️ Flagged |
| Lenco Diagnostic Laboratories,inc. | Brooklyn, NY | $101.5M | ⚠️ Flagged |
| Enzo Clinical Labs, Inc. | Farmingdale, NY | $100.1M | ⚠️ Flagged |
| Cblpath, Inc | Rye Brook, NY | $94.4M | ✓ 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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