Statistical flag only — not an accusation of fraud
This provider's $48.1M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 245% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 68/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 103% 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 | $21.95 | $3.94 | 5.57x | $18.01 | $1.6M | 399.0K | 51 |
| 2015 | $16.98 | $2.65 | 6.41x | $14.33 | $2.4M | 909.2K | 55 |
| 2016 | $9.10 | $2.43 | 3.74x | $6.67 | $2.5M | 1.0M | 73 |
| 2017 | $5.85 | $1.87 | 3.13x | $3.98 | $3.1M | 1.7M | 77 |
| 2018 | $6.07 | $1.91 | 3.18x | $4.16 | $3.8M | 2.0M | 91 |
| 2019 | $5.76 | $1.80 | 3.20x | $3.96 | $4.0M | 2.2M | 95 |
| 2020 | $9.63 | $3.08 | 3.13x | $6.55 | $8.1M | 2.6M | 106 |
| 2021 | $10.10 | $2.92 | 3.46x | $7.18 | $8.0M | 2.7M | 107 |
| 2022 | $12.04 | $3.47 | 3.47x | $8.57 | $9.1M | 2.6M | 101 |
| 2023 | $6.86 | $2.19 | 3.13x | $4.67 | $5.4M | 2.5M | 105 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 16.6M | $17.0M | $1.02 | 2.39x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 117.5K | $9.6M | $81.75 | 3.68x |
| 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 | 191.5K | $4.2M | $22.15 | 2.39x |
| 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 | 72.2K | $1.8M | $24.80 | 3.02x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 74.7K | $1.7M | $23.30 | 3.22x |
| 36415 | Insertion of needle into vein for collection of blood sample | 441.0K | $1.6M | $3.56 | 5.53x |
| 80053 | Blood test, comprehensive group of blood chemicals | 119.5K | $1.3M | $11.21 | 4.96x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 148.1K | $1.3M | $8.66 | 5.14x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 61.3K | $1.1M | $18.61 | 4.05x |
| 82306 | Vitamin d-3 level | 31.4K | $1.0M | $33.01 | 2.30x |
| 85610 | Blood test, clotting time | 180.3K | $852.5K | $4.73 | 13.16x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 60.0K | $838.4K | $13.97 | 5.45x |
| 83036 | Hemoglobin a1c level | 51.9K | $570.4K | $10.98 | 4.28x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 45.6K | $426.4K | $9.34 | 4.33x |
| 87086 | Bacterial colony count, urine | 47.0K | $423.8K | $9.01 | 4.72x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 25.7K | $422.6K | $16.44 | 5.08x |
| 81001 | Manual urinalysis test with examination using microscope, automated | 85.9K | $297.1K | $3.46 | 7.19x |
| 82746 | Folic acid level, serum | 18.2K | $292.7K | $16.05 | 4.10x |
| 82728 | Ferritin (blood protein) level | 13.0K | $199.7K | $15.31 | 4.27x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 5.0K | $193.3K | $38.80 | 3.19x |
This provider submits charges 3.53 times higher than what Medicare actually pays.
A markup ratio of 3.53x means for every $100 Medicare pays, this provider initially charges $353. 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 IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Llc Il | Wood Dale, IL | $446.2M | ⚠️ Flagged |
| Tempus Ai, Inc. | Chicago, IL | $213.4M | ⚠️ Flagged |
| Chicago Clinical Laboratories, Ltd | Northbrook, IL | $66.5M | ⚠️ Flagged |
| Lifescan Labs Of Illinois, Llc | Skokie, IL | $61.6M | ✓ Clear |
| Chicago Care Lab Services Llc | Chicago, IL | $56.7M | ⚠️ Flagged |
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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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