Statistical flag only — not an accusation of fraud
This provider's $55.1M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 7.19x is significantly above the specialty median of 3.7x.
Medicare payments to this provider grew 427% from 2020 to 2023.
This provider has been statistically flagged with a risk score of 85/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 434% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $133.33 | $14.22 | 9.38x | $119.11 | $2.9M | 205.6K | 156 |
| 2021 | $76.90 | $12.55 | 6.13x | $64.35 | $15.6M | 1.2M | 221 |
| 2022 | $64.00 | $9.88 | 6.48x | $54.12 | $21.1M | 2.1M | 232 |
| 2023 | $50.20 | $5.69 | 8.82x | $44.51 | $15.4M | 2.7M | 244 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 224.4K | $16.9M | $75.50 | 3.30x |
| 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 | 197.6K | $4.9M | $24.80 | 4.03x |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 3.3M | $3.4M | $1.05 | 1.02x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 340.3K | $2.6M | $7.67 | 10.57x |
| 80053 | Blood test, comprehensive group of blood chemicals | 248.4K | $2.6M | $10.43 | 13.43x |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 344.1K | $2.5M | $7.15 | 3.27x |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source | 87.6K | $2.2M | $25.17 | 2.26x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 119.2K | $2.0M | $16.60 | 10.36x |
| 82306 | Vitamin d-3 level | 56.7K | $1.7M | $29.26 | 12.40x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 113.9K | $1.5M | $13.23 | 10.65x |
| 83021 | Hemoglobin analysis and measurement, chromatography | 50.0K | $890.0K | $17.82 | 13.08x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 102.9K | $859.2K | $8.35 | 9.46x |
| 36415 | Insertion of needle into vein for collection of blood sample | 117.9K | $577.9K | $4.90 | 11.62x |
| 83036 | Hemoglobin a1c level | 59.6K | $572.3K | $9.60 | 16.66x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 34.4K | $512.7K | $14.89 | 14.04x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 3.3K | $457.8K | $139.79 | 5.33x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 11.5K | $447.2K | $38.73 | 9.04x |
| 87086 | Bacterial colony count, urine | 52.6K | $419.7K | $7.98 | 12.52x |
| 87088 | Bacterial urine culture | 52.1K | $414.5K | $7.95 | 12.57x |
| 82746 | Folic acid level, serum | 26.7K | $387.5K | $14.52 | 14.40x |
This provider submits charges 7.19 times higher than what Medicare actually pays.
A markup ratio of 7.19x means for every $100 Medicare pays, this provider initially charges $719. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Laboratory Corporation Of America Holdings | Raritan, NJ | $1.2B | ⚠️ Flagged |
| Quest Diagnostics Incorporated | Clifton, NJ | $927.2M | ⚠️ Flagged |
| Bioreference Health, Llc | Elmwood Park, NJ | $841.0M | ⚠️ Flagged |
| Accu Reference Medical Lab, Llc | Linden, NJ | $204.9M | ⚠️ Flagged |
| Aculabs Inc | East Brunswick, NJ | $91.5M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data