This provider's $4.4M in total Medicare payments ranks in the 78th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 8.98x is significantly above the specialty median of 3.7x.
Medicare payments to this provider grew 451% from 2016 to 2023.
68% of their billing comes from a single procedure code (G0483 — Drug test def 22+ classes).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 176% 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 |
|---|---|---|---|---|---|---|---|
| 2016 | $103.41 | $22.46 | 4.60x | $80.95 | $266.0K | 12.7K | 10.4K |
| 2017 | $113.76 | $24.61 | 4.62x | $89.15 | $309.1K | 9.2K | 6.7K |
| 2018 | $132.72 | $20.57 | 6.45x | $112.15 | $311.9K | 6.6K | 4.7K |
| 2019 | $139.10 | $42.43 | 3.28x | $96.67 | $518.8K | 4.2K | 3.5K |
| 2020 | $143.55 | $45.72 | 3.14x | $97.83 | $678.2K | 6.3K | 4.5K |
| 2021 | $156.49 | $48.93 | 3.20x | $107.56 | $352.8K | 3.7K | 2.7K |
| 2022 | $137.59 | $25.47 | 5.40x | $112.12 | $531.2K | 4.9K | 3.2K |
| 2023 | $140.01 | $24.77 | 5.65x | $115.24 | $1.5M | 10.0K | 6.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0483 | Drug test def 22+ classes | 12.0K | $2.9M | $242.42 | 12.44x |
| 80307 | Testing for presence of drug | 7.8K | $479.4K | $61.51 | 3.25x |
| 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 | 3.2K | $274.8K | $85.24 | 1.23x |
| 81226 | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants | 394 | $174.9K | $443.83 | 1.02x |
| 81225 | Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants | 389 | $111.7K | $287.16 | 1.02x |
| 82306 | Vitamin D-3 level | 1.5K | $57.3K | $37.73 | 2.64x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 2.3K | $49.9K | $21.39 | 2.69x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 2.4K | $33.0K | $13.73 | 4.39x |
| 80053 | Blood test, comprehensive group of blood chemicals | 2.9K | $31.6K | $11.01 | 4.17x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1.4K | $31.6K | $23.40 | 1.07x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 2.0K | $19.9K | $9.77 | 1.91x |
| 83036 | Hemoglobin A1C level | 1.3K | $16.0K | $12.46 | 1.61x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 840 | $15.5K | $18.40 | 2.22x |
| 84403 | Testosterone (hormone) level | 484 | $14.5K | $29.99 | 7.81x |
| 82746 | Folic acid level | 576 | $11.1K | $19.22 | 2.34x |
| 84436 | Thyroxine (thyroid chemical) measurement | 1.2K | $10.6K | $8.97 | 3.31x |
| 83550 | Iron binding capacity | 988 | $10.0K | $10.10 | 1.58x |
| 82728 | Ferritin (blood protein) level | 594 | $9.9K | $16.61 | 1.59x |
| 83735 | Magnesium level | 1.1K | $9.2K | $8.53 | 4.06x |
| 83013 | Breath test analysis for helicobacter pylori | 111 | $9.2K | $82.81 | 1.52x |
This provider submits charges 8.98 times higher than what Medicare actually pays.
A markup ratio of 8.98x means for every $100 Medicare pays, this provider initially charges $898. 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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