Statistical flag only — not an accusation of fraud
This provider's $213.4M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 787568% from 2017 to 2023.
64% of their billing comes from a single procedure code (81455 — Targeted genomic sequence analysis panel of dna or combine dna and rna of 51 or greater genes associated with blood and lymphatic system disorders).
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 10818% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $2.3K | $380.86 | 6.11x | $1.9K | $16.8K | 44 | 2 |
| 2018 | $396.92 | $265.54 | 1.49x | $131.38 | $1.8M | 6.9K | 20 |
| 2019 | $714.71 | $233.55 | 3.06x | $481.16 | $5.1M | 21.8K | 17 |
| 2020 | $551.01 | $217.69 | 2.53x | $333.32 | $11.7M | 53.6K | 20 |
| 2021 | $357.84 | $142.25 | 2.52x | $215.59 | $8.4M | 59.1K | 19 |
| 2022 | $1.4K | $982.01 | 1.38x | $378.03 | $54.4M | 55.4K | 17 |
| 2023 | $2.0K | $1.5K | 1.36x | $528.27 | $132.0M | 89.9K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81455 | Targeted genomic sequence analysis panel of dna or combine dna and rna of 51 or greater genes associated with blood and lymphatic system disorders | 47.7K | $136.5M | $2.9K | 1.33x |
| 81456 | Targeted genomic sequence analysis panel of rna of 51 or greater genes associated with blood and lymphatic system disorders | 14.7K | $42.0M | $2.9K | 1.33x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 6.0K | $11.1M | $1.8K | 1.63x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 55.5K | $4.1M | $74.03 | 2.70x |
| 88360 | Microscopic genetic analysis of tumor, manual | 38.4K | $3.7M | $96.46 | 2.07x |
| 81445 | Test for detecting genes associated with cancer of body organ | 5.9K | $3.5M | $592.43 | 6.43x |
| 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 | 39.9K | $3.5M | $88.22 | 1.25x |
| 88381 | Preparation of specimen, manual | 14.0K | $2.0M | $141.75 | 1.39x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 18.8K | $1.5M | $81.72 | 2.45x |
| 81479 | Molecular pathology procedure | 1.3K | $1.2M | $910.10 | 4.14x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 378 | $883.3K | $2.3K | 1.28x |
| 88387 | Pathologist examination, dissection, and preparation of tissue | 29.8K | $850.6K | $28.58 | 3.42x |
| 81450 | Test for detecting genes associated with blood related cancer | 543 | $408.2K | $751.78 | 5.05x |
| 81163 | Gene analysis (breast cancer 1 and 2) of full sequence | 744 | $340.8K | $458.05 | 6.17x |
| 81301 | Microsatellite instability analysis | 869 | $297.0K | $341.73 | 1.62x |
| 81272 | Gene analysis (v-kit hardy-zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence | 601 | $195.3K | $324.97 | 1.83x |
| 81235 | Gene analysis (epidermal growth factor receptor), common variants | 548 | $172.5K | $314.79 | 1.27x |
| 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 | 6.7K | $168.4K | $25.00 | 1.00x |
| 81275 | Gene analysis (v-ki-ras2 kirsten rat sarcoma viral oncogene) variants in codons 12 and 13 | 807 | $151.0K | $187.16 | 1.67x |
| 81210 | Gene analysis (v-raf murine sarcoma viral oncogene homolog b1) | 884 | $150.3K | $170.07 | 1.85x |
This provider submits charges 1.52 times higher than what Medicare actually pays.
A markup ratio of 1.52x means for every $100 Medicare pays, this provider initially charges $152. This is lower 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 |
| 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 |
| Vcare Testing Centre Corp. | Chicago, IL | $55.7M | ✓ 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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