Statistical flag only — not an accusation of fraud
This provider's $48.0M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 9387% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 74/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 629% in 2015
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 | $37.89 | $10.45 | 3.63x | $27.44 | $205.0K | 19.6K | 58 |
| 2015 | $35.53 | $9.00 | 3.95x | $26.53 | $1.5M | 166.0K | 106 |
| 2016 | $36.20 | $9.07 | 3.99x | $27.13 | $1.8M | 196.0K | 105 |
| 2017 | $49.49 | $11.95 | 4.14x | $37.54 | $2.6M | 217.0K | 110 |
| 2018 | $52.53 | $12.25 | 4.29x | $40.28 | $3.0M | 242.6K | 114 |
| 2019 | $65.36 | $12.07 | 5.42x | $53.29 | $2.8M | 234.2K | 122 |
| 2020 | $52.22 | $10.58 | 4.94x | $41.64 | $2.4M | 228.7K | 129 |
| 2021 | $71.49 | $15.56 | 4.59x | $55.93 | $5.5M | 351.2K | 139 |
| 2022 | $71.74 | $17.65 | 4.06x | $54.09 | $8.8M | 500.6K | 144 |
| 2023 | $23.71 | $11.56 | 2.05x | $12.15 | $19.4M | 1.7M | 158 |
| 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 | 1.2M | $14.2M | $11.76 | 1.13x |
| 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 | 74.0K | $5.6M | $75.01 | 4.67x |
| 83021 | Hemoglobin analysis and measurement, chromatography | 120.5K | $2.3M | $19.43 | 3.86x |
| 82306 | Vitamin d-3 level | 64.6K | $2.1M | $32.57 | 4.27x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 106.9K | $2.0M | $18.38 | 4.07x |
| 80053 | Blood test, comprehensive group of blood chemicals | 176.1K | $2.0M | $11.10 | 5.40x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 128.9K | $1.7M | $13.23 | 4.15x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 180.0K | $1.5M | $8.50 | 4.70x |
| 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 | 61.3K | $1.5M | $24.71 | 2.03x |
| 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 | 6.0K | $1.5M | $243.92 | 5.13x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 61.0K | $1.3M | $20.54 | 2.19x |
| 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 | 675.9K | $995.9K | $1.47 | 1.03x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 39.5K | $915.1K | $23.18 | 3.88x |
| 36415 | Insertion of needle into vein for collection of blood sample | 138.6K | $589.1K | $4.25 | 5.13x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 30.7K | $492.2K | $16.02 | 4.37x |
| 80307 | Testing for presence of drug, by chemistry analyzers | 7.0K | $455.0K | $64.56 | 6.66x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 8.8K | $442.9K | $50.28 | 2.99x |
| 84153 | Psa (prostate specific antigen) measurement, total | 21.9K | $440.1K | $20.08 | 4.22x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 9.2K | $369.4K | $40.32 | 2.36x |
| 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 | 3.1K | $342.3K | $112.15 | 9.65x |
This provider submits charges 3.44 times higher than what Medicare actually pays.
A markup ratio of 3.44x means for every $100 Medicare pays, this provider initially charges $344. 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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