This provider's $30.9M in total Medicare payments ranks in the 97th percentile of Clinical Laboratory providers nationally.
71% of their billing comes from a single procedure code (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).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 7720% in 2020
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 | $69.78 | $18.38 | 3.80x | $51.40 | $2.0M | 180.7K | 121.0K |
| 2015 | $61.64 | $18.56 | 3.32x | $43.08 | $1.7M | 148.6K | 98.7K |
| 2016 | $67.52 | $19.94 | 3.39x | $47.58 | $1.0M | 89.7K | 62.1K |
| 2017 | $68.67 | $16.94 | 4.05x | $51.73 | $50.0K | 4.3K | 3.6K |
| 2018 | $63.85 | $16.99 | 3.76x | $46.86 | $98.7K | 8.9K | 6.4K |
| 2019 | $60.39 | $14.80 | 4.08x | $45.59 | $79.3K | 8.1K | 5.7K |
| 2020 | $62.47 | $12.52 | 4.99x | $49.95 | $6.2M | 65.1K | 11.0K |
| 2021 | $61.59 | $11.32 | 5.44x | $50.27 | $13.3M | 268.2K | 22.7K |
| 2022 | $63.17 | $12.40 | 5.09x | $50.77 | $6.2M | 125.8K | 13.0K |
| 2023 | $68.79 | $13.63 | 5.05x | $55.16 | $297.7K | 7.6K | 2.0K |
| 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 | 258.7K | $20.9M | $80.86 | 3.09x |
| 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 | 196.8K | $4.9M | $24.95 | 1.00x |
| 80053 | Blood test, comprehensive group of blood chemicals | 49.2K | $664.0K | $13.51 | 6.74x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 18.8K | $416.0K | $22.11 | 3.66x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 28.3K | $327.5K | $11.56 | 6.38x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 30.0K | $306.8K | $10.21 | 4.90x |
| 36415 | Insertion of needle into vein for collection of blood sample | 77.9K | $229.7K | $2.95 | 5.08x |
| 83036 | Hemoglobin A1C level | 16.6K | $212.2K | $12.79 | 4.31x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 23.7K | $201.6K | $8.51 | 4.43x |
| 82306 | Vitamin D-3 level | 4.9K | $190.5K | $38.74 | 2.45x |
| 87086 | Bacterial colony count, urine | 12.6K | $134.6K | $10.64 | 5.01x |
| 80048 | Blood test, basic group of blood chemicals | 10.2K | $107.7K | $10.60 | 6.75x |
| 83970 | Parathormone (parathyroid hormone) level | 2.0K | $105.6K | $53.80 | 2.64x |
| 87077 | Bacterial culture for aerobic isolates | 9.5K | $101.4K | $10.62 | 5.28x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 2.2K | $98.9K | $45.11 | 3.51x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 8.4K | $95.6K | $11.33 | 8.96x |
| 85610 | Blood test, clotting time | 13.2K | $68.8K | $5.22 | 6.96x |
| 87493 | Detection test for clostridium difficile | 1.4K | $64.6K | $46.72 | 1.61x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 2.5K | $61.4K | $24.55 | 3.60x |
| 80069 | Kidney function blood test panel | 5.2K | $59.3K | $11.31 | 6.81x |
This provider submits charges 3.07 times higher than what Medicare actually pays.
A markup ratio of 3.07x means for every $100 Medicare pays, this provider initially charges $307. This is higher 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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